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THE 


ANATOMY 


or  THE 


HUMAN  BODY. 


BY  WILLIAM  CHESELDEN, 

Surgeon  to  his  Majesty’s  Royal  Hospital  at  Chelsea,  Fellow  of  the  Royal 
Society,  and  Member  of  the  Royal  Academy  of  Surgeons 
at  Paris. 


f 

mitfy  jTortp  Copperplates, 


SECOND  AMERICAN  EDITION, 


BOSTON: 

PUBLISHED  BY  DAVID  WEST,  N*“.  56,  CORNHIL&, 

C.  STEBBINS,  PRINTER, 

jan.  1806, 


i 


TO 


DR.  RICHARD  MEAD, 

PHYSICIAN  TO  THE  KING, 

FELLOW  OF  THE  COLLEGE  OF  PHYSICIANS 
Ijy  l o j\~d  o a; 

AND  OP  THE 

ROYAL  SOCIETY. 

sir,  y 

EVERY  part  of  PHYSIC  may  justly  pre- 
sume on  your  protection,  to  whom  it  owes  so 
much  improvement.  ANATOMY  in  particular 
has  received  such  advantage  from  your  lectures, 
that  it  were  a kind  of  injustice  not  to  dedicate 
all  endeavours  in  that  way  to  you  ; in  me,  in- 
deed, it  would  be  unpardonable  not  to  offer  the 
fruits  of  those  studies,  which  at  first  began,  and 
have  still  been  carried  on  with  your  encourage- 
ment. The  kind  reception  my  industry  has  met 
with,  is  owing  to  you,  the  authority  of  whose 


DEDICATION. 


opinion  has  in  every  place  secured  me  so  much 
favour  j especially  in  that  seat  of  learning,  which 
with  distinguished  honours  rewarded  your  merit, 

I am,  SIR, 

Tour  most  obliged  and 
Obedient  humble  servant , 


WILLIAM  CHESELDEN. 


PREFACE. 


THE  study  of  anatomy,  as  it  leads  to  the  knowl- 
edge of  nature  and  the  art  of  healing , needs  not  many 
tedious  descriptions  nor  minute  dissections  ; what  is  most 
worth  knowings  is  soonest  learned , and  least  the  subject 
of  disputes  ; while  dividing  and  describing  the  parts , 
more  than  the  knowledge  of  their  uses  requires , perplexes 
the  learner , and  makes  the  science  dry  and  difficult. 

This  edition  is  a tenth  part  larger  than  the  former  ; 1 
not  increased  by  descriptions , but  by  observations  upon  the  • 
uses  and  mechanism  of  the  parts , with  operations  and 
cases  in  Surgery. 

■ The  plates  are  more  in  number , larger ■,  better  de- 
signed, and  better  executed  than  those  which  were  in  the 
former  editions , which  has  unavoidably  enhanced  the 
price  of  this. 


CONTENTS. 


BOOK  I. 

Page 

THE  General  Introduction  1 

Introduction  to  the  Bones  4 

Chap.  I.  Of  the  Sutures  and  Bones  of  the  Cranium  11 
Chap.  II.  Of  the  Bones  of  the  Face , lAc.  17 

Chap,  III.  Of  the  Bones  of  the  Trunk  21 

Chap.  IV.  Of  the  Bones  of  the  Upper  Limbs  29 

Chap.  V_  Of  the  Bones  of  the  Lower  Limbs  34 

Chap.  VI.  Of  the  Cartilages  41 

l Of  the  Ligaments  44 


Of  the  Lubricating  Glands  of  the  Joints  47 


BOOK  II. 


Chap.  I. 

Introduction  to  the  Muscles 

61 

Chap.  1 1. 

Of  the  Muscles 

67 

BOOK  III. 

Chap.  I. 

Of  the  External  Parts , and  Common 

Integuments 

133 

Chap.  II. 

Of  the  Membranes  in  general 

141 

Chap.  III. 

Of  the  Salivary  Glands 

142 

Chap.  IV. 

Of  the  Peritonaum , Omentum , Duc- 
tus Aliment  alls,  and  Mesentery 

148 

CONTENTS. 


Page 


Chap.  V. 

Of  the  Liver,  Gall-Bladder , Pancreas , 

and  Spleen 

161 

Chap.  VI. 

Of  the  Vasa  Lactea 

163 

Chap.  VII. 

Of  the  Pleura , Mediastinum , Lungs , 

Pericardium  and  Heart 

172 

Chap.  VIII. 

Of  the  Arteries  and  Veins 

183 

Chap.  X. 

Of  the  Lymph <z ducts 

209 

Chap.  XI. 

Of  the  Lymphatic  Glands 

212 

Chap.  XII. 

Of  the  Course  of  the  Aliment  abstract- 

ed from  the  foregoing  Chapters 

216 

Chap.  XIII. 

Of  the  Dura  Mater , and  Pia  Mater 

218 

Chap.  XIV. 

Of  the  Cerebrum , Cerebellum,  Medul- 

la Oblongata , and  Medulla  Spinalis 

222 

Chap.  XV. 

Of  the  Nerves 

225 

BOOK  IV. 

Chap.  I. 

Of  the  Urinary  and  Genital  Parts  of 

• 

' 

Men,  together  with  the  Glandules 

Renales 

259 

Chap.  II. 

Of  the  Genital  Parts  of  Women 

272 

Chap.  III. 

Of  the  Foetus  in  Utero 

278 

Chap.  IV. 

Of  the  Eye 

290 

Chap.  V. 

Of  the  Ear 

304 

Chap.  VI. 

Of  the  Senses  of  Smelling , Tasting  and. 

Feeling 

310 

Chap.  VII. 

Of  Cutting  for  the  Stone 

325 

ADVERTISEMENT. 


SINCE  the  last  edition  of  this  book,  I have  pub- 
lished some  Observations  and  Cases  in  Surgery,  with 
prints  of  Operations  and  a Set  of  Chirurgical  Instru- 
ments. These  are  annexed  to  a Translation  of  Le 
Bran’s  Operations  by  Mr.  Gataker  ; and  as  some 
of  them  relate  to  my  Anatomy,  I thought  it  proper 
to  take  notice  of  them  here  : at  the  same  time,  in 
justice  to  the  merit  of  Mr.  Le  Dran,  I would  recom- 
mend a careful  perusal  of  his  Book  to  all  Practition- 
ers in  Surgery. 


W.  CHESELDEN. 


THE 


ANATOMY 


or  THE 

HUMAN  BODY. 


GENERAL  INTRODUCTION. 

It  is  a received  opinion,  that  an  animal  body  ' 
is  a compages  of  vessels,  variously  disposed,  to 
form  parts  of  different  figures,  for  different  uses. 
The  ancients  supposed  that  the  heart  and  brain 
were  first  formed,  and  that  the  other  parts  pro- 
ceeded from  them,  and  that  the  membranes  were 
derived  from  the  dura  mater,  or  pia  mater  of 
the  brain.  They  distinguished  all  the  parts  into 
spermatic  and  sanguineous  ; the  former  of  which 
they  derived  from  the  brain,  and  the  latter  from 
the  heart  ; and  frequently  engaged  in  disputes 
about  the  derivation  of  parts  ; with  many  other 
things  of  the  like  nature,  consequences  of  their 
hypotheses.  But  the  moderns,  by  the  assist- 

B 


2 


GENERAL  INTRODUCTION', 


ance  of  glasses,  having  made  more  accurate  observ 
vations,  conclude,  that  all  the  parts  exist  in  minia- 
ture, from  the  first  formation  of  the  foetus  ; and 
that  their  increase  is  only  the  extension  and  thick- 
ening of  their  vessels,  and  that  no  part  owes  its  ex- 
istence to  another.  Thus  much  I thought  neces- 
sary to  premise,  that  the  reader  might  see  for 
what  reason  no  notice  is  taken,  in  this  treatise,  of 
some  distinctions  and  divisions  of  parts,  used  by 
ancient  anatomists,  and  those  who  have  copied  af- 
ter them. 

The  constituent  parts  of  the  animal  body,  are, 
fibres,  membranes,  arteries,  veins,  lymphaeducts, 
nerves,  glands,  excretory  vessels,  muscles,  tendons, 
ligaments,  cartilages,  and  bones  j to  these  may  be 
added,  the  hair  and  nails. 

Fibres,  as  they  appear  to  the  naked  eye,  are  sim- 
ple threads  of  the  minutest  blood  vessels  or  nerves, 
or  both. 

Membranes  are  compages  of  fibres,  expanded  to 
cover,  or  line,  any  other  part. 

Arteries  are  tubes  that  arise  from  the  ventricles 
of  the  heart,  and  thence  dividing  into  branches,  dis- 
tribute the  blood  to  every  part  of  the  body. 

Veins  are  tubes  to  collect  and  return  the  blood 
from  the  extremities  of  the  arteries  to  the  heart. 

Lymphasducts  are  fine  pellucid  tubes,  to  carry 
lymph  from  all  par's,  especially  the  glands,  which 
they  discharge  into  the  larger  veins,  and  into  the 
vasa  lactea. 


GENERAL  INTRODUCTION. 


3 


Nerves  are  fasciculi  of  cylindrical  fibres,  which 
arise  from  the  medulla  oblongata  of  the  brain, 
and  the  medulla  spinalis,  and  terminate  in  ail 
the  sensitive  parts.  They  are  the  immediate  organs 
of  sensation. 

A gland  secretory,  is  composed  of  an  artery, 
vein,  lymphatic,  excretory  duct,  and  nerve.  The 
use  of  glands  is  to  secrete  fluids  from  the  blood,  for 
divers  uses. 

Excretory  vessels  are  either  tubes  from  glands 
to  convey  the  secreted  fluids  to  their  respect- 
ive places ; or  vessels  from  the  small  guts,  to  carry 
the  chyle  to  the  blood  vessels  ; these  last  are  called 
vasa  lactea. 

Muscles  are  distinct  portions  of  flesh,  which  by 
contracting,  perform  the  motions  of  the  body. 

Tendons  are  the  same  fibres  of  which  the  mus- 
cles are  composed ; but  more  closely  connected, 
that  they  may  possess  less  space  in  a limb,  and  be 
inserted  in  less  room  into  a bone. 

Ligaments  are  strong  membranes,  or  bodies  of 
fibres  closely  united,  either  to  bind  down  the 
tendons,  or  give  origin  to  the  muscles,  or  tie  to- 
gether such  bones  as  have  motion. 

Cartilages  are  hard,  elastic  bodies,  smooth  and 
insensible  ; their  use  is  to  cover  the  ends  of  the 
bones  that  have  motion,  to  prevent  their  attri- 
tion, &c. 

Bones  are  firm  parts  to  sustain,  and  give  shape 
to  the  body,  &c. 


INTRODUCTION  TO  THE  BONES. 


The  use  of  the  bones  is  to  give  shape  and 
firmness  to  the  body,  to  be  levers  for  the  mus- 
cles to  act  upon,  and  to  defend  those  parts  from 
external  injuries  that  are  of  greatest  consequence 
to  be  preserved  ; as  the  brain,  spinal  marrow, 
heart,  &c.  Their  fibres,  when  first  formed  like 
the  shells  and  stones  of  fruits,  are  very  soft,  un- 
til by  the  addition  of  a matter,  which  is  secreted 
into  them,  they  grow  by  degrees  to  the  hardness 
of  a cartilage,  and  then  perfect  bone  : but  this 
change  is  neither  made  in  a very  short  time,  nor 
begun  in  all  the  parts  of  the  same  bone  at  once. 
Flat  bones,  that  have  their  fibres  directed  to  all 
sides,  begin  to  ossify  in  or  near  a middle  point ; but 
the  cylindrical  bones,  and  all  others  whose  fibres  are 
nearly  parallel,  begin  about  the  middle  of  each  fibre, 
and  thence  shoot  forth  to  their  extremities  ; not 
always  in  continued  lines,  but  frequently  beginning 
new  ossifications,  which  soon  join  the  former  ; and 
by  the  continual  addition  of  this  ossifying  matter, 
the  bones  increase  till  their  hardness  resists  a far- 
ther extension  ; and  their  hardness  always  increas- 
ing while  they  are  growing,  the  increase  of  their 
growth  becomes  slower  and  slower,  until  they  cease 


5 


INTRODUCTION,  &C. 

to  grow  at  all.  In  old  and  consumptive  persons, 
and  sometimes  in  diseased  or  wounded  limbs,  they 
decrease  as  well  as  the  fleshy  parts,  though  not  so 
fast,  because  of  their  hardness.  Sometimes  the  os- 
sifying matter  flows  out  of  the  bones,  and  forms 
bony  excrescences  ; and  frequently  in  very  old  men 
it  fixes  on  the  arteries,  and  makes  them  grow  bony  ; 
and  when  this  happens  to  a degree,  the  arteries 
lose  their  power  to  propel  the  blood,  until  the  ex- 
treme parts  mortify.  And  though  the  cartilages 
and  arteries  are  most  subject  to  these  changes,  yet 
no  part  is  secure  from  them  ; for  I have  seen  a 
large  part  of  the  muscular  fibres  of  the  heart  itself 
perfectly  ossified.  I have  known  one  instance  of  a 
deficiency  of  this  ossifying  matter,  in  the  lower  jaw 
of  an  adult  body  ; where  all  that  part  on  one  side, 
which  is  beyond  the  teeth,  was  of  a substance  be- 
tween that  of  a cartilage  and  a ligament.  In  chil- 
dren that  have  died  of  the  rickets,  I have  found  the 
nodes  on  the  bones  soft,  spongy,  and  bloody,  and 
in  one  subject  several  of  them  as  limber  as  leather, 
and  the  periosteum  in  some  places  many  times  its 
natural  thickness ; but  the  cartilages  and  cartilagin- 
ous epiphyses  had  no  apparent  alteration  in  their 
texture,  though  some  were  swelled  to  more  than 
twice  their  natural  diameters. 

Every  cylindrical  bone  has  a large  middle  cav- 
ity, which  contains  an  oily  marrow,  and  a great 
number  of  lesser  cells  towards  their  extremities, 
which  contain  a bloody  marrow.  The  bloody 


6 


INTRODUCTION 


marrow  is  also  found  in  all  spongy  cells  of  bones. 
The  use  of  the  first  kind  of  marrow,  I imagine, 
is  to  soften,  and  render  less  brittle,  the  harder  fi- 
bres of  bones  near  which  it  is  seated  ; and  that 
the  other  marrow  is  of  the  same  use  to  the  less 
compact  fibres,  which  the  more  oily  marrow  might 
have  made  too  soft ; and  that  for  this  reason  there  is 
less  of  the  oily  marrow,  and  more  of  the  bloody, 
in  young  bones  than  in  old  ones.  Every  one  of 
these  cells  is  lined  with  a fine  membrane,  and  the 
marrow  in  the  larger  cells  is  also  contained  in 
thin  membraneous  vesicles  ; in  which  membranes 
the  vessels  are  spread,  which  enter  obliquely, 
about  the  middle  of  the  cylindrical  bones,  from 
some  of  whose  branches  the  marrow  is  secreted, 
while  others  of  them  enter  the  internal  substance 
of  the  bones  for  their  nourishment ; and  the  rea^ 
son  why  they  enter  obliquely  is,  that  they  may 
not  weaken  the  bones  by  dividing  too  many  fi- 
bres in  the  same  place.  If  the  bones  had  been 
formed  of  the  same  quantity  of  matter  without  any 
cavities,  they  would,  if  they  were  straight,  be  able 
to  sustain  the  same  weight ; but  being  made  hollow, 
their  strength  to  resist  breaking  transversely  is  in- 
creased as  much  as  their  diameters  are  increased, 
without  increasing  their  weights  ; which  mechan- 
ism being  yet  more  convenient  for  birds,  the  bones 
of  their  wings,  and  for  the  same  reason  their  quills, 
have  very  large  cavities.  But  the  bones  in  the  legs 
of  all  animals  are  more  solid,  being  formed  to  sup* 


TO  THE  BONES. 


7 


port  weight  ; and  men’s  bodies  being  supported  by 
two  limbs,  the  bones  of  those  limbs  are  therefore 
made  more  solid  than  those  of  quadrupeds.  In- 
sects, and  most  of  the  smallest  animals,  have  shelb 
instead  of  bones,  like  lobsters,  which  serve  them  al- 
so for  defence  ; and  the  muscles,  being  inserted  into 
the  shells  at  a greater  distance  from  the  centre  of 
motion  of  each  joint  than  in  animals  that  have 
bones,  their  motions  are  necessarily  slower,  stronger 
and  more  simple.  Therefore  in  this  sort  of  animals, 
quickness  of  motion,  where  it  is  wanted,  is  pro- 
cured by  a number  of  joints,  as  may  be  seen  in  the 
legs  of  a flea  ; and  variety  of  motions  by  joints 
with  different  directions,  as  may  be  observed  in  a 
lobster.  In  a fractured  bone,  in  which  the  same 
kind  of  matter  that  ossified  the  bones  at  first  is 
thrown  out  from  the  broken  ends  of  a bone,  there 
is  formed  a mass  of  callous  matter,  of  equal  solid- 
ity with  any  part  of  the  bone,  and  of  equal  or 
greater  diameter,  which  will  make  the  strength 
of  the  bone  in  that  place  greater  than  it  was  be- 
fore ; which  is  very  convenient ; for  bones,  when 
broke,  are  seldom  or  never  set  in  so  good  a direc- 
tion as  that  in  which  they  were  first  formed,  and 
therefore  they  would  be  more  liable  to  be  broke 
in  the  same  place  again,  and  would  be  reunited 
with  greater  difficulty,  and  sometimes  not  at  all, 
because  the  callus,  being  less  vascular  than  a bone, 
is  does  not  so  easily  admit  the  ossific  matter  to  flow 
through  it  to  form  a new  callus. 


INTRODUCTION 


Bones  that  are  without  motion,  as  those  of  the 
scull,  the  ossa  innominata,  &c.  also  bones  with 
their  epiphyses,  when  they  meet,  press  into  each 
other,  and  form  sutures,  which  soon  disappear  in 
those  that  join,  while  their  ossific  matter  is  soft  $ 
but  those  that  grow  harder  before  they  meet,  press 
more  rudely  into  each  other,  and  make  more  un- 
even sutures,  some  of  which  in  the  scull  endure  to 
the  greatest  age  : and  sometimes  while  a bone  is 
ossifying  from  its  centre,  a distant  part  begins  a new 
ossification,  and  forms  a distinct  bone,  which  may 
happen  to  be  of  any  figure.  These  bones  are  often- 
est  found  in  the  lambdoital  suture,  and  are  there 
called  ossa  tiiquetra.  But  the  ends  or  sides  of  bones 
that  are  intended  for  motion,  are  hindered  from 
uniting,  by  the  cartilages  which  cover  them  ; for 
when  these  cartilages  are  eroded,  the  bones  very 
readily  unite,  and  form  an  anchylosis. 

The  ends  of  all  the  bones  that  are  articulated 
for  very  manifest  motions,  or  that  are  not  placed 
against  other  bones  ; are  tipped  with  epiphyses  or 
additional  bones  ; which  in  some  measure  de- 
termine their  growth  and  figure  ; for  if  they  had 
nothing  to  give  bounds  to  them,  they  would  shoot 
out  like  the  callus  from  the  broken  ends  of  a bone 
that  is  ill  set,  and  grow  as  ragged  as  the  edges  of 
bones  which  are  joined  by  sutures  ; and  sometimes 
epiphyses  are  made  use  of  to  raise  processes  upon 
bones  for  the  insertions  of  muscles,  as  the  trochan- 
ters of  the  thigh  bones,  where  it  would  weaken 


TO  THE  BONES. 


9 


the  bones  too  much  to  have  processes  raised  out  of 
their  substance. 

The  fibres  of  bones,  for  aught  that  we  can  dis- 
cover from  experiments  or  microscopical  observa- 
tions, appear  to  be  connected  to  each  other  by  the 
same  means  that  the  parts  of  a fibre  are  connected, 
that  is,  by  the  strong  attraction  which  belongs  to 
particles  of  matter  in  contact  ; but  this  cohesion 
of  fibre  to  fibre  is  not  equal  to  that  in  the  parts  of 
a fibre,  though  very  nearly.  Indeed  if  it  was,  a 
bone  would  not  be  a structure  of  fibres,  but  one 
uniform  mass,  like  that  of  any  pure  metal,  the  co- 
hesion of  the  parts  of  which  are  every  where  alike. 
Nor  are  the  parts  of  bones  disposed  into  visible  la- 
mellae, stratum  super  stratum,  as  many  have  paint- 
ed ; for  though  young  bones  may  in  some  places 
be  split  into  lamellae,  yet  they  not  only  appear  one 
solid  uniform  mass  to  the  naked  eye,  but  even  with 
a microscope,  till  we  come  to  their  inner  spongy 
texture,  which  also  appears  uniform.  Their  tex- 
ture, when  first  formed,  is  every  where  loose  and 
spongy  : but  as  they  increase,  they  become  in  ma- 
ny places  very  compact  and  dense,  which  results  in 
great  measure  from  the  pressure  of  the  bellies  of 
the  muscles,  and  other  incumbent  parts ; as  ap- 
pears from  the  impressions  they  make  on  the  sur- 
faces of  the  bones,  and  the  rough  spines  that  rise 
on  the  bones  in  the  interstices  of  the  muscles,  which 
are  very  remarkable  in  men  who  have  been  bred 
up  in  hard  labour.  In  those  parts  of  the  flat  bones 


10 


INTRODUCTION,  &C. 

that  receive  but  little  pressure,  the  outer  laminss 
only  become  compact  and  dense,  while  the  mid- 
dle part  remains  spongy  ; but  where  the  pressure 
is  greater,  as  on  the  scapula  and  the  middle  of 
the  ilium,  they  become  in  an  adult,  one  dense 
body  or  table,  and  are  usually  thinner  in  those 
places  than  in  a child  before  it  is  born.  The  cy- 
lindrical or  round  bones,  being  pressed  most  in 
their  middles,  become  there  very  hard  and  strong, 
while  their  extremities  remain  spongy,  and  dilate 
into  large  heads,  which  make  stronger  joints,  and 
give  more  room  for  the  origins  and  insertions  of 
the  muscles  ; and  increase  the  power  of  the  mus- 
cles, by  removing  their  axis  farther  from  the 
centre  of  motion  of  any  joint  they  move. 

All  the  bones,  except  so  much  of  the  teeth 
as  are  out  of  the  sockets,  and  those  parts  of  other 
bones  which  are  covered  with  cartilages,  or 
where  muscles  or  ligaments  arise  or  are  inserted, 
are  covered  with  a fine  membrane,  which  upon 
the  scull  is  called  pericranium,  elsewhere  peri- 
osteum. It  serves  for  the  muscles  to  slide  easy 
upon,  and  to  hinder  them  from  being  lacerated  by 
the  roughness  and  hardness  of  the  bones.  It  is 
every  where  full  of  small  blood  vessels,  which  en- 
ter the  bones  for  their  nourishment ; but  the  in- 
ternal substance  of  the  larger  bones  is  nourished 
by  the  vessels  which  enter  obliquely  through 
their  middles,  as  has  been  before  observed. 


11 


SUTURES  AND  BONES,  &C. 

CHAPTER  I. 

SUTURES  AND  BONES  OF  THE  CRANIUM. 

SUTURE  is  made  by  the  mutual  indenta- 
tion of  one  bone  with  another.  Those  which 
have  proper  names  are  here  described  ; those 
which  have  not,  derive  their  names  from  the 
bones  they  surround,  and  are  known  by  them. 

Sutura  coronalis  runs  across  the  scull,  from  one 
upper  edge  of  the  sphenoidal  bone  to  the  other, 
and  joins  the  parietal  bones  to  the  frontal. 

Sutura  sagittalis  joins  the  parietal  bones  ; be- 
gins at  the  os  occipitis,  and  is  continued  to  the  os 
frontis,  in  children  down  to  the  nose  ; the  os  fron- 
ds in  them  being  two  bones,  and  sometimes  so  in 
adult  bodies. 

Sutura  tambdoidalis  joins  the  back  part  of  the 
ossa  bregmatis,  or  parietal  bones,  to  the  upper  part 
of  the  occipital : in  this  suture  are  frequently  ob- 
served small  bones  called  ossa  triquetra,  and  some- 
times in  other  sutures. 

Sutura  squamosa  is  made  by  the  upper  part  of 
the  temporal  and  spenoidal  bones  wrapping  over 
the  lower  edges  of  the  parietal  bones. 

Sutura  transversalis  runs  across  the  face  through 
the  bottoms  of  the  orbits  of  the  eyes  ; it  joins  the 
lower  edge  of  the  frontal  bone  to  the  os  spenoides, 
maxillae  superioris,  ossa  nasi,  ungues  plana,  pala- 
ti,  and  jugalia,  or  malarum. 


12 


SUTURES  AND  BONES 


The  scull  being  divided  into  many  bones,  is 
neither  so  subject  to  fractures, nor  to  have  fractures 
so  far  extended,  as  it  would  have  been  were  it 
composed  of  one  bone  only.  This  structure  is  also 
convenient  for  the  ossification  of  the  bones,  as  has 
been  already  shewn,  and  for  the  birth  ; because 
these  bones  not  being  perfect  at  that  time,  may 
be  pressed  together,  and  make  the  head  less. 

Ten  of  the  bones  of  the  head  compose  the 
cranium,  to  contain  the  brain  and  defend  it  fx'om 
external  injuries. 

Ossa  parietalia,  or  bregmatis  are  two  large 
bones  which  compose  the  superior  and  lateral  parts 
of  the  scull ; on  the  inside  they  are  remarkably 
imprinted  by  the  arteries  of  the  dura  mater. 

Os  frontis  makes  the  upper  and  fore  part  of  the 
cranium  ; its  lower  parts  compose  the  upper  parts 
of  the  orbits  of  the  eyes,  where  on  its  insides  are 
impressed  the  volvuli  of  the  brain,  which  uneven- 
nesses help  to  keep  that  part  of  the  brain  steady. 
In  its  middle  above  the  os  ethmoiaes  usually  arises 
a thin  spine,  which  strengthens  that  part  of  the 
bone,  it  being  otherwise  weak  from  its  flatness. 
In  some  sculls  this  spine  is  wanting  ; but  then  the 
bone  is  usually  thicker  in  that  place,  and  from  its 
middle,  externally,  goes  a process  which  supports 
the  bones  of  the  nose.  Immediately  above  the  os 
ethmoides  in  this  bone  is  a small  blind  hole,  through 
which  runs  a vein  into  the  beginning  of  the  longi- 
tudinal sinus  of  the  dura  mater ; and  on  the  upper 


OT  THE  CRANIUM. 


is 


edge  of  each  orbit,  a small  perforation,  or  a notch, 
through  which  nerves  and  an  artery  pass  secure  to 
the  forehead  ; it  has  also  a small  hole  in  each  orbit, 
near  the  os  planum,  through  which  passes  a branch 
of  the  fifth  pair  of  nerves.  In  the  substance  of 
this  bone  near  the  nose  are  two,  three,  four,  and 
sometimes  five  sinuses,  which  open  into  the  nose  ; 
they  differ  very  much  in  different  persons,  and  are 
very  rarely  found  in  children.  These  sinuses,  and 
the  spine  in  this  bone,  make  it  very  dangerous,  if 
not  impracticable,  to  apply  a trephine  on  the  mid- 
dle and  lower  part  of  the  forehead. 

Os  esthmoides,  or  cribriforme,  is  a small 
bone,  about  two  inches  in  circumference,  seated  in 
the  anterior  part  of  the  basis  of  the  scull,  being  al- 
most surrounded  by  the  last  described  bone.  It  is 
full  of  holes,  like  a sieve,  through  which,  it  is  said, 
the  olfactory  nerves  pass,  which  I could  never  dis- 
cover. In  its  middle  arises  a large  process  named 
crista  galli : and  opposite  to  this  a thin  one  which 
in  part  divides  the  nose.  The  greater  part  of  the 
laminae  spongiosae  in  the  nose  belong  to  this  bone. 

Os  sphenoides  is  of  a very  irregular  figure  ; it 
is  seated  in  the  middle  of  the  basis  of  the  scull, 
bounded  by  the  os  frontis,  ethmoides, vomer,  occi- 
pitis,  maxillae  superioris,  ossa  parietalia,  palati,  ma- 
larum,  temporum,  and  petrosa,  which  are  parts  of 
the  former  bones.  In  its  inside  next  the  brain  is  a 
cavity  named  sella  turcica, which  isboundedby  four 
processes  called  clinoides  : under  the  two  foremost 


14 


SUTURES  AND  BONES 


of  which  pass  the  internalcarotid  arteries, and  from 
their  outsides  are  continued  two  thin  long  processes 
upon  that  part  of  the  frontal  bone,  which  separates 
the  anterior  lobes  of  the  brain  from  the  posterior  ; 
opposite  to  the  sella  turcica  is  a process  which  makes 
part  of  the  septum  narium.  On  the  outside  of  the 
scull  adjoining  to  the  upper  jaw,  are  two  processes 
of  this  bone  on  each  side,  named  pterygoides  from 
which  arise  one  on  each  side  near  the  palate,  which 
have  no  name.  Over  these  pass  the  tendons  of  the 
pterygostaphilina  externi  muscles  ; and  nearer  to- 
wards the  occiput,  between  these  and  the  styloid 
processes  of  the  ossa  petrosa,  arise  two  more  small 
rugged  processes  ; and  under  the  sella  turcica,  in 
this  bone,  is  a sinus  or  two,  for  the  most  part,  in 
adults, but  in  children  only  such  a spongy  substance 
as  is  seen  in  the  ends  of  some  of  the  bones.  Dr. 
Nichols  observes,  this  sinus  belongs  properly  to 
the  os  ethmoides.  At  the  inside  of  the  basis  of  the 
two  antei'ior  clinoid  processes  are  two  round  holes, 
which  are  the  first  foramina  of  the  scull ; through 
these  the  optic  nerves  pass ; almost  under  these,  to- 
wards the  sides  of  the  scull,  are  two  irregular  slits, 
named  foramina  lacera,  or  the  second  foramina  of 
the  scull,  through  which  pass  nerves  and  blood 
vessels  into  the  orbits  of  the  eyes;  and  under  these, 
towards  the  occiput,  are  two  round  holes,  which 
are  the  third  foramina,  through  which  pass  nerves 
to  the  face ; about  half  an  inch  nearer  the  occiput 
are  two  more,  of  an  oval  figure,  which  are  the 


OF  THE  CRANIUM. 


15 


fourth  foramina,  through  which  pass  the  largest 
branches  of  the  fifth  pair  of  nerves  ; and  a straw’s 
breadth  farther  two  very  small  ones,  called  the  fifth 
foramina,  through  which  those  branches  of  the  ca- 
rotid arteries  enter  that  are  bestowed  upon  the  du- 
ra mater.  Between  this  last  described  bone  and 
the  ossa  petrosa,  are  two  large  rough  holes,  in 
which  I have  seen  large  veins  ; and  frbm  these 
holes,  through  part  of  the  os  sphenoides  under  the 
pterygoid  processes,  are  small  holes, through  which 
pass  arteries  to  the  back  part  of  the  nose. 

Ossa  temporum  are  situated  below  the  parie- 
tal bones,  at  the  middle  and  lower  parts  of  the 
sides  of  the  scull ; they  have  each  at  their  back 
parts  one  large  spongy  process,  called  mammilla- 
ris,  or  mastoideus,  and  from  the  lower  and  middle 
parts  of  each  a process  which  joins  the  ossa  mala- 
rum,  named  jugalis  or  zygomaticus. 

Ossa  petrosa  lie  between  the  former  bones 
and  the  occipital  bones,  or  are  truly  portions  of  the 
former  bones,  being  never  found  separate  in  adult 
bodies.  They  have  each  on  their  outsides  one  long 
slender  process  called  styliformis,  and  near  the  side 
of  this  process  a foramen,  which  runs  obliquely 
forwards  into  the  scull,  through  which  the  carotid 
arteries  pass  to  the  brain  ; these  are  the  sixth  fora- 
mina, and  one  foramen  in  the  inside  of  the  scull 
leading  to  the  organs  of  hearing, which  are  the  sev- 
enth foramina.  The  ridge  on  the  upper  parts  of 
each  of  these  bones  helps  to  keep  the  brain  steady, 


16 


SUTURES  AND  RONES 


and  are  strong  supports  to  the  thin  and  flat  parts 
of  the  scull,  which  else  would  be  exceeding  weak. 
What  remains  of  this  bone  belongs  properly  to  a 
discourse  on  the  organs  of  hearing. 

Between  the  last  described  bones  and  the  fol- 
lowing bone  are  two  large  holes,  which  are  the 
eighth  foramina.  Through  these  holes  pass  the 
eighth  pair  of  nerves  and  lateral  sinuses  some- 
times they  are  two  on  each  side,  one  for  the  nerve 
and  one  for  the  sinus.  To  these  we  may  add  an- 
other very  small  one  on  each  side,  through  which 
pass  the  portiones  durae  of  the  auditory  nerves  ; 
and  sometimes  there  is  another  for  an  artery. 

Os  occipitis  makes  all  the  back  part  of  the 
scull ; it  is  bounded  by  the  sphenoidal,  temporal, 
petrosal,  and  parietal  bones  ; it  has  two  small, 
apophyses,  by  which  it  is  articulated  to  the  spine 
near  those  apophyses  are  two  small  foramina, 
which  are  the  ninth  of  the  scull ; through  these 
pass  the  ninth  pair  of  nerves ; and  between  these 
is  the  great  or  tenth  foramen,  through  which  the 
medulla  oblongata  descends  into  the  spine,  the  cer- 
vical arteries  enter,  and  the  cervical  veins  pass  out. 
In  the  inside  of  this  bone  is  a crucial  spine  im- 
pressed by  the  longitudinal  and  lateral  sinuses  : 
and  on  the  outside,  opposite  to  the  middle  of  this 
spine,  in  some  bodies,  is  an  apophysis,  and  from, 
that  down  to  the  great  foramen  a small  thin  spine. 
The  spines  in  this  bone  are  of  the  same  use  with 
those  in  the  os  frontis,  &c.  viz.  to  strengthen  it. 


OF  THE  CRANIUM. 


17 


The  thinner  parts  of  this  bone  are  also  defended  by 
the  muscles  that  cover  them  ; which  provision  is 
very  necessary,  because  we  can  least  defend  this 
part,  and  blows  here  are  of  worse  consequence  than 
on  any  other  part  of  the  scull,  because  wounds  in 
the  cerebellum,  which  is  underneath,  are  mortal. 
There  are  in  most  sculls  a foramen  behind  each 
apophysis  of  the  occipital  bone  ; through  which 
pass  sinuses  from  the  lateral  sinuses  to  the  external 
cervical  veins:  by  means  of  these  communications, 
as  in  all  other  communications  of  the  sinuses,  the 
blood  passes  from  those  that  happen  to  be  sur- 
charged by  any  posture  of  the  head,  into  those 
that  from  the  same  posture  would  have  been  al- 
most empty.  Such  sculls  as  want  these  foramina 
have  two  sinuses  for  the  same  purpose. 


CHAPTER  II. 

OF  THE  BONES  OF  THE  FACE,  &C. 

Ossa  nasi  make  the  upper  part  of  the  nose  ; 
they  form  that  kind  of  arch  which  is  fittest  to  sus- 
tain such  injuries  as  the  nose  is  most  exposed  to. 

Ossa  malarum.  These  bones  compose  the  an- 
terior, lower,  and  outer  parts  of  the  orbits  of  the 
eyes  ; they  have  each  a short  process,  which  pro- 
cess joins  the  processus  jugales  of  the  temporal 


18 


OF  THE  BOKES 


bones,  and  form  arches  which  have  been  called' 
ossa  jugalia. 

Ossa  ungues  are  seated  immediately  below  the 
os  frontis  towards  the  nose  in  the  orbits  of  the 
eyes  ; whose  anterior  and  inner  parts  they  help 
to  compose  ; and  between  each  of  them  and  the 
upper  jaw  is  a foramin  as  large  as  a goose  quill,  in- 
to which  the  punctalacrymalia  lead,  to  carry  off any 
superfluous  moisture  from  the  eyes  into  the  nose. 

Ossa  plana  are  seated  immediately  beyond  the 
foregoing  bones,  in  the  orbits  of  the  eyes,  and 
are  near  thrice  as  big.  They  are  rather  smooth 
surfaces  of  the  os  spongiosum,  than  distinct  bones., 
and  are  very  often  imperfect. 

Maxilla  superior  is  always  described  single 
' though  it  is  manifestly  divided  by  a suture  which 
, is  scarce  ever  obliterated ; it  has  two  processes, 
< which  join  the  os  frontis,  and  make  part  of  the 
nose  ; and  another,  which  joins  to  the  cartilage  of 
the  septum  nasi.  Its  upper  and  outward  parts  make 
the  lower  parts  of  the  orbits  of  the  eyes ; its  lower 
side,  all  that  part  of  the  face  under  the  cheeks, 
eyes, .and  nose  to  the  mouth,  and  two  thirds  of  the 
roof  of  the  mouth.  A little  below  the  orbits  of  the 
eyes,  in  this  bone,  are  two  holes,  and  behind  the 
dentes  incisores  one  more,  which  divides  into  two, 
as  it  opens  into  "the  nose,  on  each  side  of  the  sep- 
tum nasi.  Between  the  posterior  grinding  teeth 
and  the  orbits  of  the  eyes  are  two  great  sinuses, 
called  antra  maxillae  superioris,  which  open  in  the 


OF  THE  FACS. 


19 


nipper  part  of  the  nose.  And  in  the  lower  edge  of 
this  jaw  are  the  alveoli,  or  sockets  for  the  teeth. 

Part  of  the  sides  of  these  cavities,  that  lie  next  the 
-nose,  are  only  membranes  which  make  the  cavities 
like  drums,  perhaps  to  give  a grave  sound  to  the 
voice  when  we  let  part  of  it  through  the  nose  ; 
but  brutes  not  needing  such  variety  of  sounds,  have 
these  cavities  open  to  the  nose,  and  filled  with  la- 
mellae, which  are  covered  with  membranes,  in 
which  the  olfactory  nerves  terminate,  for  a more 
exquisite  sense  of  smelling  than  is  necessary  for 
men.  Imposthumations  sometimes  happen  in 
these  cavities  : the  signs  of  this  disease  are,  great 
pain  about  the  part,  matter  in  the  nose  on  the  side 
diseased,  stinking  breath,  and  rotten  teeth.  Mr. 
Cowper  first  described  this  case,  and  the  cure  ; ^ 

which  is  performed  by  drawing  out  the  last  tooth  * 
but  one,  or  two,  or  more  if  rotten  ; and  through 
their  socketsmakingaperforation,intothe  antrum; 
or  if  drawing  a tooth  makes  a perforation,  which 
sometimes  happens,  and  perhaps  gave  the  first  hint 
of  this  cure,  then  that  opening  must  be  enlarged, 
if  it  is  not  sufficient  to  discharge  the  matter. 

Ossa  palati  are  two  small  bones  that  make 
the  back  part  of  the  roof  of  the  mouth,  and  a small 
part  of  the  bottom  of  each  orbit.  Between  the  ossa 
palati  and  osmaxillare  near  the  pterygoid  processes 
of  the  sphenoidal  bone,  are  too  small  foramina, 
through  which  arteries  and  nerves  pass  to  the  pal- 
ate. 


20 


OF  THE  BONES 


Os  Vomer  is  seated  between  the  bones  of  the 
palate,  and  the  sphenoidal  bone.  It  is  also  joined  to 
the  process  of  the  ethmoides,  and  part  of  the  low- 
er jaw.  Its  fore  part  is  spongy,  and  is  continued 
to  the  middle  cartilage  of  the  nose.  This  bone 
and  cartilage  are  the  septum  nasi. 

Os  spongiosum  is  usually  treated  as  a distinct 
bone,  though  it  is  only  the  spongy  laminae  in  the 
nose,  of  the  os  ethmoides  and  ossa  plana, but  chiefly 
of  the  os  ethmoides,  to  which  it  always  adheres. 
In  considering  these  lamellae  as  a distinct  bone,  we 
follow  the  ancients,  who  did  not  distinguish  the 
bones  of  the  scull  only,  as  they  are  divided  by  su- 
tures, but  according  to  the  differences  of  their  tex- 
ture, figure,  situation,  or  use.  Thus  they  called 
these  parts  os  spongiosum ; a process  of  the  tempo- 
ral bone,  joined  to  the  os  malae,  os  jugale,  &c. 

Maxilla  inferior  is  articulated  with  loose  car- 
tilages to  the  temporal  bones,  by  two  processes, 
named  condyloides.  Near  these  arise  two  more, 
called  coronales,  and  at  the  inside  of  the  chin  a 
small  rough  processus  innominatus.  In  the  inside 
of  this  bone,  under  each  processus  coronalis,  is  a 
large  foramin,  which  runs  under  the  teeth,  and 
passes  out  near  the  chin.  In  this  foramen,  the  ves- 
sels pass  that  belong  to  the  teeth  ; and  in  the  upper 
edge  of  this  jaw  are  the  sockets  for  the  teeth,  which 
seldom  exceed  sixteen  in  each  jaw  ; the  four  first 
in  each  are  called  incisores,  the  two  next  canini, 
the  rest  molares  5 the  four  last  of  these  are  named*" 


OF  THE  FA-CE. 


21 


dentes  sapientiae,  because  they  do  not  appear  till 
men  arrive  at  years  of  discretion.  The  incisoresand 
canini  have  only  one  single  root,  but  the  molares 
more;  the  eight  first,  two;  and  the  rest,  some  three, 
some  four,  especially  in  the  upper  jaw;  where  also 
they  are  spread  wider,  because  that  jaw  being  more 
spongy  than  the  other,  the  teeth  need  more  space 
to  fix  them.  Each  of  these  roots  has  a foramen, 
through  which  pass  an  artery,  vein,  and  nerve, 
which  are  expanded  in  a fine  membrane  that  lines 
the  cavity  in  each  tooth.  These  vessels  and  mem- 
brane are  the  seat  of  the  tooth-ache.  The  teeth  of 
children  cast  off  while  they  are  growing ; but  the 
succeeding  teeth  arise  in  new  sockets,  deeper  and 
larger  than  the  former,  for  the  jaws  increasingfast- 
er  than  the  teeth,  must  otherwise  have  left  chasms 
between  them,suchas  are  in  the  mouths  of  brutes ; 
but  where  teeth  are  drawn  in  adult  bodies,  the 
sockets  close,  and  new  ones  very  rarely  succeed. 

CHAPTER  IE. 

OF  THE  BONES  OF  THE  TRUNK. 

The  bones  of  the  trunk  are  those  which  com- 
pose the  spine  or  chain  of  bones  from  the  head 
down  to  the  rump,  the  ribs  and  sternum,  to  which 
may  justly  be  added  the  the  ossa  innominata. 

The  spine  is  composed  of  twenty-four  vertebrae 
(each  of  which  in  a young  child  is  three  bones) 


22 


er  THE  BONES 


'besides  those  of  the  os  sacrum  and  coccygis  ; sev- 
en belong  to  the  neck,  the  first  of  which  is  called 
atlas,  because  it  immediately  supports  the  head ; 
its  upper  side  has  two  cavities,  into  which  the  apo- 
physes of  the  os  occipitis  are  received  ; but  these 
two  cavities  together,  unlike  all  other  joints,  are 
laterally  portions  of  concentric  circles,  by  which 
means  they  are  but  as  one  joint,  and  so  suffer  the 
head  to  move  easily  side-ways,  which  otherwise  it 
could  no  more  do  than  the  knee,  which  also  has 
two  heads  and  two  cavities.  The  under  side  of 
this  bone  has  a very  flat  articulation  with  the  next, 
which  fits  it  for  a rotatory  motion.  The  second 
vertebra  is  called  dentata,  or  axis,  from  a process 
which  passes  through  the  former  bone,  and  is  the 
axis  upon  which  it  turns  ; nevertheless  all  the  ver- 
tebrae of  the  neck  contribute  something  to  the  ro- 
tatory motion  of  the  head.  The  processus  denta- 
tus  is  strongly  tied  to  the  os  occipitis,  and  to  the 
atlas  by  ligaments  to  prevent  its  hurting  the  spi- 
nal marrow.  Twelve  of  which  belong  to  the 
bacjc,  five  to  the  loins.  The  os  sacrum  is  some- 
times five,  sometimes  six  bones,  and  the  os  occygis 
four.  If  this  chain  had  been  composed  of  fewer 
bones,  they  must  have  either  not  been  capable  of 
bending  so  much  as  they  do,  or  have  bent  more 
in  each  joint,  which  would  have  pressed  the  spinal 
marrow,  the  ill  consequences  of  which  are  suffi- 
ciently seen  in  persons  grown  crooked,  or  who 
have  had  distortions  from  external  accidents. 


OF  THE  TRUNK. 


23 


The  uppermost  vertebrae  of  the  neck  being 
fixed  behind  the  centre  of  gravity  of  the  head,  the 
neck  is  therefore  so  far  bent  forward  as  that  the 
last  of  these  vertebrae  (which  has  a firm  bearing 
upon  these  of  the  thorax)  may  be  exactly  under 
the  centre  of  gravity.  Those  of  the  thorax  are 
bent  backwards,  behind  the  centre  of  motion,  to 
make  room  for  the  parts  contained  in  the  thorax ; 
and  that  they  might  not  be  made  too  weak  by  the 
structure,  they  are  formed  for  less  motion  than 
other  vertebrae  ; and  those  in  particular,  which  are 
bent  farthest  from  the  centre  of  gravity  have  the 
least  motion.  The  middle  vertebrae  of  the  loins 
are  again  bent  forwards  under  the  centre  of  grav- 
ity, or  near  it  ; and  from  thence  they  go  back- 
wards to  the  os  sacrum,  where  being  fixed  to  the 
ossa  innominata  behind  the  centre  of  gravity,  the 
articulation  is  therefore  firm  and  without  motion, 
and  from  thence  the  ossa  innominata  are  so  form- 
ed, as  that  their  sockets,  into  which  the  thigh 
bones  are  fixed,  where  there  is  a free  motion,  are 
exactly  under  the  centre  of  gravity.  In  brutes 
the  spine  is  differently  formed,  according  to  the 
actions  for  which  they  are  designed. 

In  all  these  vertebrae,  except  the  first,  is  a mid- 
dle anterior  spongy  body,  by  which  they  are  firm- 
ly articulated  with  a very  strong  intervening  liga- 
ment ; and  from  the  middle  of  the  hind  part  of 
each,  except  the  first,  stands  a process  named  spi- 
nalis, and  from  every  one  a process  on  each  side.. 


24 


OF  THE  BONEd 


called  transversalis,  and  two  superior,  and  two  in- 
ferior short  ones ; by  which  the  back  parts  of  the 
vertebrae  are  articulated,  named  obliqui,  superio- 
res,  and  inferiores. 

The  fore  part  of  the  seven  vertebrae  of  the 
neck,  and  two  upper  of  the  back,  are  flat  for- 
wards, to  make  room  for  the  aspera  arteria  an- 
gula  : the  third  and  fourth  of  the  back  acute  to 
give  way  to  the  vessels  of  the  lungs  and  heart,  and 
bent  to  the  right  side  for  the  better  situation  of 
the  heart,  which  makes  that  side  of  the  breast 
more  convex  than  the  other,  and  therefore  strong- 
er ; which  seems  advantageous  to  the  right  arm, 
its  motions  depending  upon  the  support  it  receives 
from  the  breast.  Hence,  I think,  it  seems,  that 
( the  almost  universal  preference  of  that  arm  is  not 
1 an  arbitrary  thing,  but  founded  upon  observation, 
that  it  is  capable  of  more  perfect  actions  than  the 
other. 

The  spinal  processes  of  the  second,  third,  fourth, 
and  fifth  vertebrae  of  the  neck  are  forked,  the  two 
last  long  and  horizontal,  the  three  or  four  upper 
ones  of  the  back  like  them,  only  a little  declining, 
the  middle  ones  of  the  back  run  obliquely  down- 
wards, and  the  processes  of  the  remaining  vertebrae 
become  successively  thicker,  stronger,  and  less  de- 
clining ; those  of  the  loins  being  horizontal,  like 
the  last  of  the  neck.  The  muscles  that  are  inserted 
into  the  spinal  processes  of  the  vertebrae  of  the 
neck  and  loins  will  act  with  more  strength  than  those. 


OF  THE  TRUNK. 


25 


of  the  back,  because  their  processes  being  perpendic- 
ular to  the  spine,  they  are  longer  levers  ; besides, 
those  of  the  back  almost  touch  one  another,  to  pre- 
vent much  motion,  because  it  would  interrupt  res- 
piration ; but  more  motion  being  necessary  in  the 
neck  and  loins,  their  processes  are  made  fit  for  it. 

The  transverse  processes  of  the  vertebrae  of  the 
neck  are  perforated,  for  the  admission  of  the  cer- 
vical blood  vessels,  and  bowed  downwards,  and 
hollowed,  for  the  passages  of  the  cervical  nerves. 
The  eight  or  nine  upper  ones  of  the  back  receive 
the  upper  ribs  ; and  the  rest,  with  those  of  the 
loins,  serve  only  for  origins  and  insertions  of  mus- 
cles. 

Os  sacrum  has  two  upper  oblique  processes, 
some  small  spinal  processes,  and  two  foramina  in 
each  interstice  of  the  bones  it  is  composed  of,  both 
before  and  behind.  Ossa  coccygis  have  none  of 
these  parts. 

Through  every  bone  of  the  spine,  the  ossa 
coccygis  excepted,  is  a large  foramen,  which  to- 
gether make  a channel  through  the  spine,  in  which 
is  contained  the  medulla  spinalis  ; and  in  each 
space  between  the  vertebrae  are  two  large  holes  for 
the  nerves  to  pass  out. 

It  is  worth  considering  the  provision  which  is 
made  to  prevent  luxations  in  this  chain  of  bones, 
such  luxations  being  worse  than  any  other,  because 
of  the  spinal  marrow  which  is  contained  within  these 
bones.  The  bodies  of  the  vertebrae  are  all  in  the 


26 


o?  the  bone;; 

same  manner  connected  by  strong  interveningliga- 
ments  or  cartilages.  In  the  neck  the  oblique  pro- 
cesses of  the  received  bone  are  wrapped  over  those 
of  the  receiving  bone,  which  forbids  their  luxating 
forwards.  The  transverse  processes,  with  a small 
apophysis  of  the  body  of  the  same  bone,  in  like 
manner,  secure  them  from  slipping  backwards  ; 
and  an  apophysis  on  each  side  of  the  body  of  the 
receiving  bone,  hinders  them  from  slipping  to  either 
side.  The  vertebrae  of  the  back  are  hindered  from 
dislocating  forwards  by  the  same  provision  with 
those  of  the  neck  ; and  from  luxating  backwards, 
by  the  ribs  which  are  fastened  to  the  transverse  pro- 
cesses of  the  inferior  vertebrae, and  against  the  back 
part  of  the  body  of  the  next  superior  : they  also 
( hinder  them  from  dislocating  to  either  side  ; but 
1 the  last  ribs  are  not  fixed  to  the  transverse  processes 
of  the  vertebrae  of  the  back,  and  therefore  it  is  that 
luxations  are  most  frequently  seen  in  this  part ; but 
the  vertebrae  of  the  loins  are  received  into  deep 
cavities,  and  are  tied  with  much  stronger  ligaments 
for  their  security.  Each  joint  of  the  vertebrae,  ex- 
cept the  two  uppermost,  has  two  centres  of  mo- 
tion, one  upon  the  bodies  of  the  vertebrae,  when 
the  trunk  is  bowed  forward  \ and  the  other  at  the 
articulations  of  the  oblique  processes,  when  the 
body  is  bowed  backwards ; from  which  structure 
the  extensors  will  have  about  twice  the  lever  to 
act  with,  and  consequently  twice  the  power  to  raise 
the  trunk  into  an  erect  posture,  that  they  have  to 


OF  THE  TR'I/NX. 


27 


carry  it  beyond  that  posture : for  then  the  oblique 
processes  begin  to  be  the  centre  of  motion,  and  give 
a like  advantage  to  the  benders.  Without  this 
contrivance  it  would  be  more  difficult  to  keep  the 
body  erect,  or  to  recover  an  erect  posture  with 
considerable  strength  after  a bend  of  the  body. 

The  ribs  are  twelve  in  number  on  each  side  ; 
the  seven  uppermost  are  called  true  ribs,  because 
their  cartilages  reach  the  sternum  ; and  the  five 
lowest  are  called  bastard  ribs.  They  are  articulated 
to  the  bodies  of  the  twelve  vertebrae  of  the  back, 
and  all,  except  the  two  or  three  last,  are  articulat- 
ed to  their  transverse  processes,  and  the  under 
side  of  the  middle  ribs  are  hollowed  for  the  passage 
of  the  intercostal  vessels.  They  defend  the  parts 
contained  in  the  breast,  and  when  they  are  drawn 
upwards,  the  cavity  of  the  breast  is  enlarged  for 
inspiration,  and  so  the  contrary.  In  two  children, 
which  I have  dissected,  I found  the  ribs  broke  in- 
wards, and  on  the  outside  a very  plain  print  of  a 
thumb  and  fingers,  occasioned  by  their  nurses  tak- 
ing hold  of  their  breasts,  and  hoisting  them  up  on 
one  hand,  which  being  often  repeated,  had  broke 
the  ribs  inwards  like  a green  stick,  without  separat- 
ing the  broken  ends  of  them.  I have  also  very  fre- 
quently seen  the  shape  of  children’s  breasts  quite 
spoiled  by  such  tricks,  which  have  occasioned  weak- 
ness of  body,  crookedness,  and  other  diseases. 

Sternum,  or  breast-bone,  is  generally  made  up 
-of  three  spongy  bones,  sometimes  more ; to  this  the 


28 


OF  THE  BONES 


two  ribs  are  articulated  by  their  cartilages,  which 
sometimes  in  robust  men  have  moveable  joints, 
such  as  are  seen  in  oxen,  and  other  quadrupeds. 
At  the  end  of  the  sternum  is  the  cartilago  ensifor- 
mis,  so  called  from  its  shape,  but  it  very  often  is 
double  ; there  is  also  frequently  found  variety  in 
the  form  of  the  cartilages,  which  join  the  ribs  and 
sternum;  sometimes  one  cartilage  serving  two  ribs; 
and  sometimes  a cartilage  not  joined  to  any  rib  ; 
frequently  in  old  persons  we  find  parts  of  them  os- 
sified, and  I have  twice  found  them  totally  ossified 
.in  men  between  forty  and  fifty  years  of  age,  both 
of  which  died  with  a great  difficulty  of  breathing ; 
and  besides,  one  had  a jaundice,  and  the  other  a 
dropsy,  but  the  lungs  in  both  were  very  sound. 

There  are  seldom  found  fewer  than  four  and 
twenty  vertebra in  the  spine,  besides  the  os  sacrum, 
but  often  more  ; sometimes  thirteen  of  the  back, 
with  as  many  ribs  of  a side  : and  sometimes  six  in 
the  loins,  and  in  some  bodies  two  ribs  from  the  first 
vertebra  of  the  loins,  but  then  it  has  wanted  trans- 
verse processes. 

Os  Innominatum  is  in  young  persons  compos- 
ed of  three  bones  ; the  upper  is  named  ilium, 
the  lower  and  posterior  os  ischii,  and  the  anterior 
os  bubis : the  upper  edge  of  the  ilium  is  called  its 
spine,  the  anterior  part  of  the  spine  its  apex,  and  a 
little  lower  is  the  processes  innominatus.  Ilium 
has  two  processus,  the  one  named  the  obtuse  pro- 
cess, and  the  other  the  acute  ; in  the  centre  of 


OF  THE  TRUNK. 


29 


these  bones  is  the  acetabulum  or  socket  for  the 
thigh  bone  ; in  the  bottom  of  which  socket  is  an- 
other cavity,  in  which  lies  the  lubricating  gland  of 
this  joint.  When  impostumations  happen  in  this 
joint  they  usually  cause  a great  swelling  and  lame- 
ness in  the  hip,  which,  in  time,  makes  a collection 
of  matter  in  the  external  part  of  the  hip  ; how- 
ever, this  is  not  the  only  way  it  proceeds,  for  I 
have  twice  seen  the  matter  in  the  joint  make  way 
through  the  bottom  of  the  acetabulum  into  the  pel- 
vis of  the  abdomen  ; in  these  cases,  when  the  pa- 
tient went  to  stool,  the  matter,  by  straining,  was 
pressed  out  through  the  external  wound. 


CHAPTER  IV. 

BONES  OF  THE  UPPER  LIMB. 

Clavicula  is  connected  at  one  end  to  the 
sternum  with  a loose  cartilage,  and  at  the  other 
to  the  processus  acromion  of  the  scapula  ; its 
chief  use  is  to  keep  the  scapula  a sufficient  distance 
from  the  breast,  by  which  means  the  shoulders  are 
hindered  from  coming  near  together,  as  they  do  in 
those  quadrupeds  which  use  their  fore  limbs  only 
to  walk  on,  and  not  as  men  do  their  hands. 

Scapula  is  fixed  to  the  sternum  by  the  clavi- 
cula, but  its  chief  connection  is  to  the  ribs  and 


50 


BONES  OF  THE 


spine,  by  those  muscles  which  are  made  also  for  its 
various  motions ; and  in  such  quadrupeds  as  have 
no  clavicles  it  is  fixed  only  by  muscles,  whose 
actions  give  to  this  bone  a great  deal  of  that  mo- 
tion which  seems  to  be  in  the  joint  of  the  shoulder. 
The  under  side  of  this  bone  is  a little  concave, 
partly  to  fit  to  the  outer  surface  of  the  ribs  on 
which  it  moves,  and  partly  to  give  room  for  the 
sub-scapularis  muscle.  On  the  outside  arises  a 
large  spine  ; the  fore  part  of  which  is  called  the 
processus  acromion,  to  which  the  clavicula  is  fixed. 
In  men  and  such  quadrupeds  as  have  clavicles,  and 
use  their  fore  limbs  like  arms,  this  process  and 
spine  are  much  larger  and  more  prominent,  not 
only  for  the  better  fixing  the  clavicle,  but  also  to 
( remove  the  muscles  farther  from  the  centre  of 

c motion,  whereby  they  are  able  to  move  a greater 

weight.  Near  this  process  is  another  called  cora- 
coides,  from  whose  extremity,  with  like  advan- 
tage, arise  two  muscles  of  the  arm  ; this  process 
with  the  former  and  a flat  ligament  between  them 
both,  hinder  the  os  humeri  from  being  dislocated 
upwards.  The  side  opposite  to  the  socket  is  called 
the  basis  of  the  scapula,  and  the  lower  edge  costa 
inferior  from  its  figure,  which  is  thick,  and  like  a 
rib  to  the  scapula  ; but  its  upper  edge  being  very 
thin,  is  improperly  so  called  in  the  human  skele- 
ton, though  not  so  in  many  quadrupeds.  At  the 
fore  part  of  this  edge,  close  to  the  coracoid  pro- 
cess, is  a semicircular  nich  for  the  passage  of  blood 


UPPER.  LIMB. 


31 


vessels,  which  nich  is  joined  at  top  with  a liga- 
ment, and  sometimes  with  bone. 

Os  humeri : its  upper  end  or  head,  where  it  is 
joined  to  the  scapula,  is  somewhat  flat,  and  much 
larger  than  the  socket  which  receives  it.  At  the 
upper  part  are  two  processes  for  the  insertions  of 
muscles  of  the  arms  ; between  these  processes  is  a 
long  channel,  in  which  lies  a tendon  of  the  biceps 
cubiti.  At  the  lower  end  are  two  considerable 
processes,  both  formed  to  give  origins  to  muscles 
of  the  wrist  and  fingers  ; and  the  flexors  of  these 
joints  being  much  more  considerable  than  the  ex- 
tensors, the  inner  process  from  which  the  flexors 
arise  is  therefore  much  larger  than  the  outer,  from 
which  the  extensors  take  their  origins  : between 
these  processes  is  the  joint.  That  part  to  which 
the  upper  end  of  the  radius  is  fixed,  is  fitted  not 
only  for  the  motion  of  the  elbow,  but  also  for  the 
rotatory  motion  of  the  radius  ; the  rest  of  this 
joint  is  made  of  portions  of  unequal,  but  concen- 
tric circles,  like  the  shanks  of  quadrupeds  ; which 
inequality  prevents  the  ulna  from  dislocating  side- 
ways, which  so  small  a joint  with  so  much  motion 
would  be  very  subject  to.  Of  a like  use  is  the  little 
sinus  on  the  fore  part  of  the  humerus,  and  the  large 
one  behind  ; the  first  of  which  receives  a process 
of  the  ulna  when  the  arm  is  bent,  and  the  other, 
the  olecranon,  when  the  arm  is  extended. 

Ulna  : at  the  upper  end  it  has  one  large  pro- 
cess called  olecranon,  and  a small  process  on  the 


52 


BONES  OF  THE 


fore  part  ; and  on  one  side  between  these  is  also 
a small  cavity  which  receives  the  upper  end  of 
the  radius  for  its  rotatory  motion  ; and  down  the 
side  of  this  bone,  next  the  radius,  is  a sharp  edge, 
from  which  the  ligament  arises,  which  connects 
those  bones  together.  At  the  lower  end  is  a pro- 
cess, called  styliformis,  and  a round  head,  which  is 
received  into  the  radius  for  the  rotatory  motion 
of  the  cubit. 

Radius  : its  upper  end  is  received  into  the  ulna, 
and  joined  to  the  humerus,  in  a manner  chiefly  fit- 
ted for  its  rotatory  motion,  for  the  strength  of  the 
elbow  joint  receives  but  little  advantage  from  the 
union  of  these  two  bones.  A little  below  this 
head  is  a large  tubercle,  into  which  the  biceps 
muscle  is  inserted,  which  by  the  advantage  of  this 
insertion  turns  the  cubit  supine,  as  well  as  bends 
it.  At  the  lower  end,  which  is  thicker,  is  a socket 
to  receive  the  carpus,  and  at  the  side  next  the  ulna 
a small  one  to  receive  that  bone,  and  a thin  edge,, 
into  which  the  transverse  ligament,  which  arises 
from  the  ulna,  is  inserted.  This  ligament  ties 
these  bones  conveniently  and  firmly  together  : for 
the  ulna  being  chiefly  articulated  to  the  os  hume- 
ri, and  the  radius  to  the  carpus,  a weight  at  the 
hand,  without  this  ligament,  would  be  liable  to 
pull  these  bones  asunder. 

Of  the  bones  of  the  hand  : Carpus  is  composed 
of  eight  bones  of  very  irregular  forms,  undoubted- 
ly the  properest  that  can  be  ; yet  why  in  these 


UPPER  LIMB. 


33 


forms,  rather  than  any  other,  no  one  has  been 
able  to  shew.  They  have  all  obscure  motions  one 
with  another,  and  with  those  of  the  metacarpus  ; 
but  the  motion  of  those  of  the  first  rank,  or  or- 
der, with  those  of  the  second  is  more  considerable, 
and  are  moved  by  the  same  muscles  which  move 
the  carpus  on  the  radius.  The  metacarpus  con- 
sists of  four  bones  which  sustain  the  fingers  ; that 
of  the  fore  finger  having  the  least  motion,  and 
that  of  the  little  one  the  most : the  other  ends  of 
these  bones  have  round  heads  for  the  articulations 
of  the  fingers  but  the  other  joints  of  the  fingers 
double  heads  and  sockets.  The  thumb  is  shorter 
and  stronger  than  any  of  the  fingers,  because  in 
its  actions  it  is  to  resist  them  all.  The  first  joint 
is  very  singular,  each  bone  receiving  and  being 
equally  received.  The  bones  of  the  fingers  on 
the  inside  are  flat  and  a little  hollow,  which  is  nec- 
essary to  make  room  for  the  flexors  of  the  fingers, 
and  to  render  their  shape  proper  for  grasping  ; 
but  this  lessening  their  diameters,  and  consequent- 
ly weakening  them  in  the  direction  in  which  they 
are  most  liable  to  be  broke,  such  inconvenience  is 
provided  against  by  a larger  substance. 


34 


BONES  OF  THE 


CHAPTER  V. 

BONES  OF  THE  LOWER  LIMB. 

Os  Femoris  at  its  upper  end  has  a round  head 
which  is  received  into  the  socket  of  the  os  in- 
nominatum.  In  most  quadrupeds  this  head  is  ob- 
long, and  makes  a firmer  articulation  ; but  that 
shape  will  not  allow  of  so  much  motion  as  a round- 
er head.  The  two  processes  near  the  head  are  call- 
ed the  greater  and  lesser  trochanters,  which  are 
evidently  formed  for  the  insertion  of  muscles,  as 
the  neck  which  lies  between  these  and  the  head,  is 
formed  to  make  room  for  that  necessary  quantity 
of  muscles  which  are  seated  on  the  inside  of  the 
thigh,  and  also  by  projecting  outwards  to  make 
long  levers  for  the  muscles,  which  are  inserted 
into  its  upper  and  external  parts.  Between  the 
great  trochanter  and  the  neck  is  a large  sinus,  into 
which  muscles  are  inserted  : between  the  two  tro- 
chanters is  a remarkable  roughness  for  the  same  use, 
from  which  begins  the  linea  aspera.  The  middle 
of  this  bone,  for  the  conveniency  of  the  muscles, 
is  bent  forwards,  which  would  make  it  subject  to 
break  backwards,  if  there  was  not  a strong  ridge 
on  the  back  side,  which  strengthens  it  sufficiently, 
and  serves  also  for  advantageous  insertions  for  sev- 
eral muscles  ; this  ridge  is  called  the  linea  aspera. 
At  the  lower  end  of  this  bone  are  two  large  heads. 


LOWER  LIMB. 


called  the  outer  and  inner  apophyses  : these  are  so 
contrived,  partly  from  being  projected  backwards, 
and  partly  from  their  shapes,  as  to  remove  the  cen- 
tre of  motion  very  far  behind  the  axis  of  the  bone, 
which  gives  great  power  to  the  muscles  that  ex- 
tend this  joint  to  raise  the  whole  weight  of  the 
body,  though  it  lessens  the  power  of  the  benders 
which  move  the  leg  only  ; between  these  pro- 
cesses the  large  vessels  descend  securely  to  the  leg. 

Patella  is  seated  on  the  fore  part  of  the  knee  ; 
its  first  appearance  is  in  the  centre  of  the  tendon, 
through  which  it  soon  extends,  until  the  tendinous 
fibres  are  lost,  and  appear  to  be  converted  into 
bone  ; however,  when  this  bone  is  broke,  the  orig- 
inal tendinous  fibres  seem  to  prevail,  seeing  the 
broken  parts,  unlike  all  other  bones  when  frac- 
tured, unite  with  a tendon-like  substance,  which 
is  rarely  converted  into  bone,  and  especially  in 
those  cases  where  the  joint  recovers  with  most 
motion  ; its  use  is  to  secure  the  extensors  of  the 
tibia,  lest,  passing  over  the  joint,  they  might  be 
too  much  exposed  to  external  injuries  ; it  also  in- 
creases the  advantage  (mentioned  in  the  last  para- 
graph) of  removing  the  common  axis  of  the  exten- 
sors of  the  tibia  farther  from  the  centre  of  motion, 
and  is  a most  convenient  medium  for  those  mus- 
cles to  unite  in,  to  perform  one  common  action. 

Tibia,  the  shin  bone,  is  large  at  its  upper  end, 
where  are  too  shallow  sockets  which  receive  the 
thigh  bone  ; between  these  is  a rough  process,  to 


36 


BONES  OF  THE 


which  the  cross  ligaments  of  this  joint  are  con- 
nected. Near  the  upper  end  is  a process,  inta 
which  the  ligament  or  tendon  of  the  patella  is  in- 
serted, and  at  the  lower  end  is  the  process,  which 
makes  the  inner  ancle,  and  secures  this  bone  from 
dislocating  outwards.  Towards  the  upper  end 
this  bone  is  triangular,  and  even  concave  on  the 
side  next  the  muscles  to  make  room  for  them  ; 
but  lower,  as  the  muscles  grow  less  and  tendinous, 
the  bone  grows  rounder  ; that  being  upon  the 
whole  a stronger  form  yet  it  is  not  made  so 
strong  as  the  thigh  bone,  though  it  bears  a greater 
weight,  which  it  is  able  to  dp  by  being  straighter, 
shorter,  and  bearing  the  weight  of  the  body  in  a 
more  perpendicular  direction. 

Fibula  is  seated  on  the  outside  of  the  tibia  ; 
its  upper  end  is  joined  to  that  bone  below  the  joint 
of  the  knee,  and  its  lower  end  is  received  into  a 
shallow  sinus  of  the  same  bone,  and  below  that 
makes  the  external  ancle  ; which  process,  with  the 
process  of  the  tibia,  strengthens  the  ancle  joint, 
which  nevertheless,  being  so  small,  would  have 
been  not  strong  enough,  if  it  had.  been  made  for 
more  motion.  It  is  doubtful  to  me,  whether  or 
not  this  bone  contributes  to  the  support  of  the 
body  ; but  its  great  use  is  for  the  origins  of  mus- 
cles, and  even  its  shape  is  suited  to  theirs. 

Of  tire  bones  of  the  foot : Tarsus  is  composed 
of  seven  bones,  the  first  of  which,  called  astraga- 
lus, supports  the  tibia,  and  is  supported  by  the  oa 


LOWER  LIMB. 


37 


adds,  which  being  projected  backwards,  makes  a 
long  lever  for  the  muscles  to  act  with,  that  extend 
the  ancle  and  raise  the  body  upon  the  toes.  These 
two  bones  have  a considerable  motion  between 
themselves,  and  the  astragalus  also  with  the  os  na- 
viculare,  and  all  the  rest  an  obscure  motion  one 
with  another, and  with  the  bones  of  the  metatarsus, 
the  greatest  part  of  these  motions  being  towards 
the  great  toe,  where  is  the  greatest  stress  of  action: 
these  bones  thus  giving  way  are  less  liable  to  be 
broke,  and,  as  a spring  under  the  leg,  make  the  mo- 
tions of  the  body  in  walking  more  easy  and  grace- 
ful, and  the  bones  which  are  supported  by  them 
less  subject  to  be  fractured  in  violent  actions.  To 
these  join  five  others,  called  the  metatarsal  bones  ; 
that  which  supports  the  great  toe  is  much  the  larg- 
est, there  being  the  greatest  stress  in  walking  j 
under  the  end  of  this  lie  the  two  sesamoid  bones, 
which  are  of  the  same  use  as  the  patella  the  great 
toe  has  two  bones,  the  lesser  three  each,  the  two 
last  of  the  least  toes  frequently  grow  together. 

Children  are  sometimes  born  with  their  feet 
turned  inwards,  so  that  the  bottom  of  the  foot  is 
upwards  : in  this  case  the  bones  of  the  tarsus,  like 
the  vertebrae  of  the  back  in  crooked  persons,  are 
fashioned  to  the  deformity.  The  first  knowledge 
I had  of  a cure  of  this  disease  was  from  Mr.  Pres- 
grove,  a professed  bone-setter,  then  living  in 
Westminster.  I recommended  the  patient  to  him, 
not  knowing  how  to  cure  him  myself.  His  way  was 


38 


BONKS  OF  THE 


by  holding  the  foot  as  near  the  natural  posture  as 
he  could,  and  then  rolling  it  up  with  straps  of 
sticking  plaster,  which  he  repeated  from  time  to 
time,  as  he  saw  occasion,  until  the  limb  was  re- 
stored to  a natural  position,  but  not  without  some 
imperfection,  the  bandage  wasting  the  leg,  and 
making  the  top  of  the  foot  swell  and  grow  larger. 
After  this,  having  another  case  of  this  kind  under 
my  care,  I thought  of  a much  better  bandage, 
which  I had  learnt  from  Mr.  Cowper,  a bone-set- 
ter at  Leicester,  who  set  and  cured  a fracture  of  my 
own  cubit  when  I was  a boy  at  school.  His  way 
was,  after  putting  the  limb  in  a proper  posture,  to 
wrap  it  up  in  rags  dipped  in  the  whites  of  eggs, 
and  a little  wheat  flower  mixed  j this  drying,  grew 
stiff,  and  kept  the  limb  in  a good  posture.  And  I 
c think  there  is  no  way  better  than  this  in  fractures, 
for  it  preserves  the  position  of  the  limb  without 
strict  bandage,  which  is  the  common  cause  of 
mischief  in  fractures.  When  I used  this  method 
to  the  crooked  foot,  I wrapt  up  the  limb  almost 
from  the  knee  to  the  toes,  and  caused  the  limb  to 
be  held  in  the  best  posture  till  the  bandage  grew 
stiff,  and  repeated  the  bandage  once  a fortnight. 

The  bones  are  subject  to  diseases  from  all  the 
same  causes  that  the  other  parts  are,  but  either  from 
their  hardness,  insensibility,  or  other  causes,  they 
neither  are  so  frequently  diseased,  nor  do  their  dis- 
eases appear  so  various  ; and  it  is  generally  of  more 
consequence  what  texture  the  diseased  bone,  or  part 


LOWER  LIMB. 


39 


of  the  hone  is  of,  than  from  what  cause  that  disease 
proceeded  ; for  when  diseases  happen  upon  the 
surfaces  of  the  hard  bones,  they  usually  admit  a 
cure  by  exfoliation  ; but  when  matter  is  made  in 
the  spongy  ends  of  the  cylindrical  bones,  or  in  the 
bodies  of  other  spongy  bones,  the  matter,  what- 
ever was  the  first  cause,  insinuates  itself  through 
those  spongy  cells,  swelling  the  bone,  and  making 
generally  an  incurable  caries ; but  if  the  matter  is 
corrosive,  it  often  ulcerates  these  parts  ; and  usu- 
ally makes  so  large  a discharge  as  to  destroy  the 
patient  where  the  part  diseased  cannot  be  extir- 
pated, which  is  often  the  case  when  matter  is 
made  in  the  bones  in  scrophulous  habits. 

The  venereal  disease  rarely  attacks  any  but  the 
hardest  parts  of  the  bones,  very  soon  raising  large 
tumours  and  caries  or  mortification  ; but  these  ca- 
rious parts  of  bones  from  this  or  other  causes  are 
but  partially  mortified  ; for,  were  they  perfectly 
so,  the  sound  and  unsound  parts  would  separate, 
though  the  integuments  were  not  taken  off ; 
whence  it  happens,  that,  where  there  is  a good  hab- 
it of  body,  carious  bones  are  often  endured  many 
years  without  much  inconvenience ; and  we  find 
from  experience,  that  such  separations  are  not  to  be 
made  till  the  diseased  part  is  laid  bare  and  perfectly 
mortified  by  being  exposed  to  the  air,  &c.  and  then 
the  sound  part  underneath  separating  from  the  un- 
sound, there  first  granulates  a fungous  flesh-like  ap- 
pearance, which  ought  never  to  be  treated  with  cor- 


40 


BONES  OF  THE 


rosive  medicines,  it  constantly  shrinking  and  harden- 
ing  of  itself,  being  the  same  substance  which  shoots 
from  the  ends  of  broken  bones,  where  also  it  soon 
shrinks  and  converts  into  a callus  to  reunite  them. 

There  is  a caries  distinct  from  these,  which  I 
have  only  seen  in  two  patients  who  died  after  a 
long  rheumatic  disorder,  in  which  the  outer  sur- 
face of  all  the  hardest  bones,  as  the  middle  of  the 
cylindrical  bones,  and  the  top  of  the  scull,  in  one 
which  I boiled,  and  in  the  other  as  far  as  I was 
.allowed  to  examine,  I found  the  outer  part  every 
where  crumbly  or  scaly,  falling  into  pieces  like 
dust  or  sand,  with  very  little  appearance  of  tumour 
any  where,  and  no  appearance  of  disease  in  the 
spongy  parts. 

Sometimes  matter  is  formed  in  the  large  me- 
dullary cavities  of  the  cylindrical  bones,  which  con- 
stantly increasing  and  wanting  vent,  partly  by  cor- 
roding and  rendering  the  bone  carious,  and  partly 
by  pressure,  tear  asunder  the  strongest  bone  in  an 
human  body,  of  which  I have  known  several  in- 
stances. In  one  case  where  the  matter  had  suffic- 
ient discharge  by  an  external  caries  formed  together 
with  the  internal  one,  all  the  internal  hard  part  of 
the  bone  which  contains  the  medulla  was  separated 
from  the  rest ; and  being  drawn  out  through  the 
place  where  the  external  caries  made  a vent,  the  pa- 
tient received  a perfect  cure.  In  another  case  of 
this  kind,  where  the  internal  part  which  contains 
the  medulla  was  also  separated  from  the  reft,  and 


LOWER  LIMB. 


41 


there  beingholes  through  which  the  matter  was  dis  - 
charged,but  none  sufficient  to  take  out  the  exfoliat- 
ed bone ; the  matter  continued  to  flow  in  great  quan- 
tity till  it  destroyed  the  patient  ; and  possibly,  if 
this  case  had  been  rightly  known,  the  internal  ex- 
foliated part  might  have  been  taken  out,  and  the 
patient  cured.  In  both  these  cases,  it  seems  as  if 
only  so  much  of  the  internal  part  of  the  bone  was 
become  carious,  as  receives  nourishment  from  the 
artery  which  enters  the  middle  of  the  bone ; and  as 
a caries  is  a mortification  of  a bone,  might  not  this 
disease  arise  from  a hurt  in  the  vessel  which  nour- 
ishes that  particular  part  ? 


CHAPTER  VI. 

CARTILAGES,  LIGAMENTS,  &C. 

Evert  part  of  a bone  which  is  articulated  to 
another  bone  for  motion,  is  covered  or  lined  with 
a cartilage,  as  far  as  it  moves  upon,  or  is  moved 
upon  by  another  bone  in  any  action  ; for  carti- 
lage being  smoother  and  softer  than  bone,  it  ren- 
ders the  motions  more  easy  than  they  would  have 
been,  and  prevents  the  bones  wearing  each  other 
in  their  actions. 

In  each  articulation  of  the  lower  jaw,  there  is  a 
loose  cartilage,  upon  which  the  condyloid  process 
moves  on  one  side,  while  the  jaw  is  moved  to  the 


42 


CARTILAGES, 


other;  and  the  two  processes  being  thus  raised  at 
once  ; the  jaw  is  thrust  forward.  These  cartilages 
are  also  found  in  animals  that  chew  the  cud,  but 
not  in  beasts  of  prey,  as  far  as  I have  examined, 
their  articulations  being  also  deeper  and  firmer  ; and 
in  the  otter  particularly,  sections  of  the  sockets, 
which  receive  the  condyloid  processes  of  the  lower 
jaw,  are  more  than  half  circles ; so  that  the  jaw 
cannot  be  dislocated  directly  without  breaking  the 
sockets.  This  structure  renders  the  motions  of  the 
jaw  more  firm,  as  that  with  intervening  cartilages 
makes  it  more  loose  and  voluble.  There  are  also 
cartilages  of  this  kind  between  the  clavicles  and 
the  sternum. 

In  the  joint  of  the  knee  are  two  loose,  almost 
annular  cartilages,  which  being. thick  at  their  outer 
edges,  and  thin  at  their  inner  ones,  they  make  the 
greatest  parts  of  the  two  sockets  in  this  joint.  The 
use  of  these  cartilages  is  to  make  variable  sockets  to. 
suit  the  different  parts  of  the  lower  end  of  the  os 
femoris  ; for  none  but  a round  head  and  a round 
cavity  can  suit  in  motion,  unless  the  shape  of  one 
or  the  other  alters  : and  it  is  plainly  necessary,  that 
thisdower  end  of  the  os  femoris  should  be  flattish, 
and  projected  backward,  to  give  advantage  to  the 
muscles  that  extend  the  tibia,  by  setting  the  centre 
of  motion  backward  : which  mechanism,  though 
It  equally  lessens  the  power  of  those  muscles  which 
bend  this  joint,  is  yet  of  great  service,  because  the 
extendingmuscles  move  this  joint  under  the  weighs 


43 


LIGAMENTS,  &C. 

©f  the  whole  body,  but  the  flexors  only  raise  the 
legs ; and  as  no  head  or  socket  moves  so  easily  as 
round  ones,  here  seems  to  be  some  provision  made 
against  the  inconvenience  of  a flattish  head  and  cav- 
ity,  by  having  the  friction  made  upon  two  surfaces, 
the  os  femoris  upon  the  loose  cartilages,  and  the 
loose  cartilages  upon  the  tibia.  This  contrivance 
is  practised  by  mechanics,  where  the  friction  of^ 
the  joints  of  any  of  their  machines  is  great,  as  be- 
tween the  parts  of  hook-hinges  of  heavy  gates, 
and  between  the  male  and  female  screws  of  large 
vices,  where  they  usually  place  a loose  ring. 

There  are  other  cartilages  which  serve  to  give 
shape  to  parts.  Of  this  sort  are  the  ciliary  cartil- 
ages at  the  edge  of  the  eye-lids,  the  cartilages  of 
the  outer  ears,  and  those  which  compose  the  low- 
er part  of  the  nose,  which  have  this  particular  ad- 
vantage in  these  places,  that  they  support  and 
shape  the  parts  as  well  as  bones  do,  and  without 
being  liable  to  be  broke  ; and  to  these  might  be 
added  those  of  the  larynx,  but  they  do  not  belong 
properly  to  the  skeleton. 

Bones  that  are  articulated  for  motion  are  tied 
together  by  very  strong  ligaments,  to  prevent 
their  dislocating,  which  also  surround  the  joints 
to  contain  their  lubricating  mucus.  The  thick- 
ness and  strength  of  these  ligaments  are  propor- 
tioned to  the  actions  of  the  several  joints,  and 
their  lengths  are  no  more  than  sufficient  to  allow 
^ proper  quantity  of  motion  ; but  the  forms  of 


44 


CARTILAGES, 


them  are  different  according  to  the  different  ac- 
tions of  the  several  joints. 

The  bones  of  the  limbs  that  move  to  all  sides 
have  ligaments  like  purses,  which  arise  from  or 
near  the  edges  of  the  sockets  of  the  receiving  bones, 
and  are  inserted  all  round  the  received  bones  a little 
below  their  heads.  The  beginnings  of  these  liga- 
ments, from  the  edges  of  the  sockets  of  the  scapula 
and  os  innominatum,  are  very  hard,  almost  cartila- 
ginous, which  serves  in  the  scapula  to  make  a larg- 
er socket,  and  such  an  one  as  will  alter  the  figure 
as  the  bone  moves,  for  the  reason  I have  mentioned 
in  the  loose  cartilage  of  the  knee  : for  the  head  of 
theos  humeri,  not  being  an  exact  portion  of  a sphere, 
requires  such  a socket,  and  the  hard  part  of  this  lig- 
ament of  the  socket  of  the  os  innominatum,  makes 
the  socket  deeper  than  the  semidiameter  of  the 
socket,  by  which  means  the  articulation  is  made 
stronger  without  any  hindrance  to  motion,  because 
it  will  give  way  to  the  neck  of  the  os  femoris  when 
it  presses  against  it ; and  the  thigh  bone  being  more 
disposed  to  be  dislocated  upwards  than  any  other 
way, the  upper  side  of  this  burfal  ligament  is  made 
exceeding  flrong  to  prevent  fuchan  accident.  From 
the  lower  edsre  of  the  acetabulum  or  focket  of  the 

O 

os  innominatum  arifes  a ligament  about  an  inch 
long,  called  teres,  or  rotundum,  which  length  is 
necessary  for  that  quantity  of  motion  which  this 
joint  has  in  human  bodies  ; it  also  hinders  the  os 
femoris  from  dislocating  upwards,  but  downwards 


45 


LIGAMENTS,  &C, 

it  will  suffer  it  to  go  far  out  of  the  socket ; but  in 
brutes  the  head  of  the  os  femoris  being  oblong, 
and  the  cavity  suitable,  there  can  be  only  a rota- 
tory motion,  which  in  effect  will  be  very  little 
more  than  that  kind  of  motion  which  is  called 
bending  and  extending  ; and  this  never  removing 
the  end  of  the  head  of  the  bone  far  in  the  socket, 
a short  ligament  is  enough  for  it,  and  will  better 
keep  the  bone  in  its  place  ; and  therefore  it  is  that 
theirs  is  so  short.  This  ligament  in  men  may  also 
serve  to  press  the  gland  in  the  bottom  of  the  aceta- 
bulum or  socket. 

The  ligaments  of  those  joints  which  admit  only 
.of  flexion  and  extension,  differ  from  the  former 
in  this,  that  they  are  much  shorter  and  stronger  at 
the  sides  of  the  joints,  and  thinner  backward  and 
.forward.  Besides  these  ligaments,  in  the  middle 
and  back  part  of  the  joint  of  the  knee,  are  two  very 
strong  ligaments,  which  arise  from  a process  at  the 
end  of  the  tibia.  They  cross  each  other  in  such  a 
manner,  as  is  best  to  secure  the  joint  from  being 
displaced  any  way ; they  also  hinder  the  extensors 
of  the  tibia  from  pulling  that  bone  too  far  for- 
wards, and  are  so  connected  to  the  semilunar  carti- 
lages, as  to  move  them  as  the  joint  moves  ; be- 
sides these,  in  this  joint  is  another  small  one,  which 
arises  from  the  os  femoris,  and  ends  in  the  fatty 
membrane  which  it  supports.  The  knee,  I think, 
cannot  be  completely  dislocated  without  breaking 
jthe  cross  ligaments  : I have  seen  this  case  but  once, 


46 


CARTILAGES, 


the  bone  indeed  was  easily  restored  to  its  place, 
but  to  no  purpose. 

The  bones  of  the  carpus  and  tarsus  are  tied  to- 
gether by  ligaments  running  promiscuously  upon 
their  surfaces  from  one  to  another  5 which  at  the 
under  side  of  the  tarsus  are  vastly  strong,  because 
they  support  the  whole  body  ; these  ligaments  to- 
gether contain  the  mucus  forall  those  joints.  There 
is  also  to  the  carpus  a strong  ligament,  which  runs 
from  the  fifth  bone  to  the  eighth,  and  the  process 
of  the  fourth  bone  : the  proper  use  of  this  is,  to 
bind  down  the  tendons  of  the  muscles  that  bend 
the  fingers. 

The  processus  dentanus  of  the  second  vertebra  is 
tied  to  the  scull  by  a ligament,  and  kept  close  to 
the  forepart  of  the  first  vertebra  by  another  in  that 
vertebra,  that  it  may  not  bruise  the  spinal  mar- 
row ; and  when  either  this  ligament  or  process  is 
broke,  it  makes  that  sort  of  broken  neck  which  is 
attended  with  sudden  death.  All  the  bones  of  the 
vertebrae,  and  every  joint  that  is  without  motion, 
and  not  joined  by  a suture,  as  the  ossa  innominata 
with  each  other,  and  the  os  sacrum  with  the  ossa 
innominata,  are  joined  by  intervening  ligaments, 
or,  as  they  are  commonly  called,  cartilages.  The 
ossa  innominata  are  also  tied  by  very  strong  liga- 
ments which  run  from  the  back  parts  of  the  spines 
of  the  ossa  ilia  to  the  os  sacrum,  and  other  liga- 
ments which  go  from  the  os  sacrum,  and  os  coccy- 
gis  to  the  acute  and  obtuse  processes  of  the  ossa  is- 


LIGAMENTS,  &C.  4.7 

chia  : these  ligaments  serve  also  for  origins  of  mus- 
cles. Towards  the  great  foramen  of  the  ossa  inno- 
minata  the  acetabulum  has  a deep  notch,  from  the 
one  side  to  the  other  of  which  runs  a ligament 
which  completes  the  socket ; this  ligament  is  some- 
time ossified  : a ligament  somewhat  like  this  there 
is  between  the  processes  of  the  scapula. 

From  the  edge  of  the  ilium  to  that  of  the  os 
pubis,  runs  a ligament  which  is  contiguous  to, 
and  appears  to  be  a part  of,  the  tendons  of  the  mus- 
cles of  the  abdomen  ; its  use  is  to  cover  the  iliac 
vessels  as  they  descend  to  the  thigh.  Under  this 
ligament,  together  with  the  vessels,  I have  often 
seen  a rupture  of  matter,  and,  I think,  sometimes 
of  the  gut,  from  the  abdomen  into  the  anterior 
part  of  the  thigh,  immediately  below  the  groin  : 
however,  I dare  affirm  this  to  be  a possible  case. 

It  is  generally  agreed,  that  the  ligaments  are  in- 
sensible,and  the  reason  assigned  is,  that  they  would 
else  be  injured  by  ordinary  motions.  But  they  are 
much  better  contrived  ; seeing  none  of  them,  not 
even  those  which  lie  between  the  vertebrae,  are  sub- 
ject to  attrition  ; but  the  other,  experience  shews, 
are  capable  of  very  acute  pains ; there  being  not 
any  thing  ourpatients  more  grievously  complain  of, 
than  collections  of  matter  within  these  parts,  or 
sharp  medicines  applied  to  them,  when  laid  bare. 

Every  joint,  where  the  bones  are  faced  with  a 
cartilage  for  a sliding  motion,  is  furnished  with 
small  glands,  which  separate  a mucilaginous  mat- 


48 


CARTILAGES, 


ter  for  the  lubricating  of  the  ends  of  the  bones,  that: 
they  may  move  easily  upon  one  another  ; and  that 
there  may  be  no  waste  of  this  necessary  fluid,  it  is 
contained  in  the  investing  ligaments  ; which  for 
this  very  reason,  are  no  where  divided,  except  to 
communicate  with  the  ligaments  of  the  tendons. 

These  glands  are  generally  seated  in  a little  fat 
near  the  insertion  of  the  ligaments,  that  they  may 
be  compressed  by  them  when  the  joints  are  in  mo- 
tion ; which  is  a proper  time  to  have  their  fluid 
pressed  out.  The  most  considerable  parcel  of  these 
glands,  with  their  fat,  are  seen  in  the  joint  of  the 
knee,  and  the  largest  gland  of  this  sort  is  found  in 
the  sinus  at  the  bottom  of  the  acetabulum  of  the 
os  innominatum,  and  is  compressed  by  the  liga- 
mentum  teres. 

The  diseases  of  the  joints  either  happen  from 
ulcers  in  the  lubricating  glands,  which,  pouring  out 
matter  that  cannot  be  discharged,  foul  the  ends 
of  the  bones,  or  else  from  swellings  in  the  ends  of 
the  respective  bones.  Either  of  these  in  time  create 
excessive  pain,  which  appears  to  me  to  be  chiefly 
irtthe  ligamentsof  the  joints, notwithstanding  what 
has  been  said  of  the  insensibility  of  these  parts. 
When  a joint  is  much  swelled  and  painful,  with- 
out external  inflammation,  it  is  vulgarly  called  a 
white  swelling,  and  more  properly  so  than  spina 
ventosa.  It  is  sometimes  in  the  beginning  cured 
by  evacuations,  but  when  the  limb  wastes  below 
the  swelling,  and  the  fingers  or  toes  of  the  limb 


49 


LIGAMENTS,  &C. 

grow  thinner  at  their  joints,  and  lose  their  shape, 
the  case  then  is  absolutely  irrecoverable.  Some- 
times the  ends  of  the  bones  erode,  then  join  togeth- 
er and  form  an  anchylosis,  which,  though  a severe 
disease  of  itself,  yet  it  is  often  a remedy  of  one  that 
is  much  worse.  In  like  manner  the  bones  of  the 
hands  and  feet,  when  they  are  ulcerated,  sometimes 
unite,  and  are  thus  preserved  from  total  ruin.  But 
there  is  one  case  of  a white  swelling  that  is  amazing, 
where  the  pain  is  so  great  that  we  are  forced  to 
take  off  the  limb,  and  yet  neither  find  upon  dissec- 
tion the  ligaments  or  glands  diseased,  nor  matter  in 
the  joint,  nor  the  bones  carious,  or  any  diseased  ap- 
pearance, except  that  the  ends  of  the  bones  are  a lit- 
tle larger  and  softer.  * 

j 

>■■■  % 


H 


50 


TABLES. 


TABLE  I. 

A,  The  skeleton  of  a child  twenty  months  old,  in 
which  all  the  bones  differ  in  shape  from  those 
of  an  adult.  The  scull  is  much  larger  in  pro- 
portion, and  the  bones  of  the  limbs  without 
those  roughnesses  and  unevennesses  which  af- 
terwards appear  ; their  texture  is  every  where 
more  loose  and  spongy,  and  their  outlines  what 
the  painters  call  tame  and  insipid  ; their  ex- 
tremities are  separate  and  formed  cartilaginous, 
which  is  accurately  distinguished  in  the  plates 
by  the  manner  of  graving. 

B,  The  thigh  bone  of  a man,  sawed  through,  in  the 
middle  of  which  is  seen  the  cavity  which  con- 
tains the  oily  marrow,  and  at  the  extremities  the 
lesser  cells,  which  contain  the  bloody  marrow. 
The  white  line  across  the  head  of  this  bone,  be- 
ginning at  the  fingers  of  the  skeleton,  is  the 
place  where  the  epiphysis  and  the  bone  are  unit- 
ed. A like  line,  across  the  lower  end  of  this 
bone,  shews  there  the  same  thing. 

G,  The  os  bregmatis  of  a foetus  six  months  old, 
which  shews  the  fibres  ossifying  from  the  centre 
to  the  circumference. 


T^B.I 


J>.  So 


c 


' 


/ 


/* 


. 


) 


TABLES. 


TABLE  II. 

1 Os  frontis. 

2 Os  bregmatis. 

3 Os  temporis. 

4 Os  occipitis. 

5 Os  malse. 

6 Os  maxillae  superior  is. 

7 Os  nasi. 

8 Os  planum. 

9 Processus  mastoideus. 

10  Processus  styloides. 

1 1 Processus  pterygoides. 

12  Dentes. 

13  Processus  coronalis. 

14  Processus  condyloides. 

15  Dentes. 


52 


TABLES. 


TABLE  III. 

1 Os  frontis. 

2 Os  bregmatis. 

3 Os  occipiti?. 

4 S'eila  turcica. 

5 A process  of  the  os  sphenoides,  making  part  of 

the  septum  nasi. 

6 A process  of  the  os  ethmoides,  making  part  of 

the  septum  nasi. 

7 Vomer. 

8 Crista  galli,  before  which  is  seen  in  shadow  the 

sinus  frontalis. 

9 The  cornua  of  the  os  sphenoides. 

10  Sella  turcica. 

11  Os  frontis. 

12  Crista  galli  and  os  ethmoides. 

13  Sinus  frontales, 

1 4 Sella  turcica. 

1 5 The  fifth  foramen. 

16  Processus  jugales. 

17  Os  petrosum. 

18  Foramen  magnum. 

19  The  outside  of  the  os  occipitis. 


TARDJ. 


P.53. 


TABLES. 


S3 


TABLE  IV.  * 

1 The  second  vertebra  of  the  neck. 

2 The  transverse  processes  of  the  vertebrae  of  the 

neck. 

3 Clavicula. 

4 The  processus  acromion  of  the  scapula. 

5 Os  humeri. 

6 The  ribs. 

7 The  transverse  processes  of  the  vertebrae  of  the 

loins. 

8 The  os  sacrum  and  os  coccygis. 

9 Os  ilium. 

10  Os  ischium. 

11  Os  pubis. 

12  Os  femoris. 


t 


54 


tables. 


> TABLE  V. 

1 The  under  side  of  the  first  vertebra  of  the  neck. 

2 A side  view  of  the  second  vertebra. 

3 The  processus  dentatus  of  the  second  vertebra. 

4 The  under  side  of  the  oblique  process. 

5 The  spinal  process. 

6 The  under  side  of  the  body  of  the  seventh  ver- 

tebra of  the  neck. 

7 The  transverse  processes. 

8 The  oblique  processes. 

9 The  spinal  process. 

10  The  spinal  process  of  the  second  vertebra  of  the 

back. 

1 1 The  under  and  fore  side  of  the  body  of  the  ver- 

tebra. 

12  The  transverse  processes. 

13  The  upper  oblique  processes  of  the  third  verte- 

bra of  the  back. 

14  The  transverse  processes, 

15  The  spinal  process. 

16  The  body  of  the  third  vertebra  of  the  loins,' 

17  The  transverse  processes. 

18  The  upper  oblique  processes. 

19  The  spinal  process. 


TAB  .V, 


T.3'4 


TAB  VI. 


P.S5 


TABLES. 


55 


TABLE  VL 

1 The  head  of  the  os  humeri. 

2 The  outer  extuberance. 

3 The  inner  extuberance. 

4 That  part  which  joins  with  the  ulna. 

5 The  olecranon  of  the  ulna. 

6 The  lower  end  of  the  ulna  which  joins  to  the 

radius. 

7 Processus  styloides. 

8 The  upper  end  of  the  radius. 

9 The  tubercle. 

10  The  part  of  the  radius  which  joins  with  the 
carpus. 

11,  12,  13,  14,  15,  16,  17,  IP,  The  eight  bones  • 
of  the  carpus. 


56 


TABLES. 

TABLE  VIL 

1 Radius. 

2 Ulna. 

3 Carpus. 

4 The  three  bones  of  the  thumb. 

5 The  four  bones  of  the  metacarpus 

6 The  three  bones  of  the  fingers. 


c . 


k 


T AS  Vir. 


P.56 


* 


: 


TAB.VUf. 


TABLES, 


57 


TABLE  VIII. 

1 The  head  of  the  os  femoris. 

2 The  great  trochanter, 

3 The  lesser  trochanter. 

4 The  lower  end  which  articulates  with  the  tibia, 

5 The  upper  end  of  the  tibia. 

6 The  lower  end  of  the  tibia. 

7 The  process  which  makes  the  inner  ancle. 

8 The  upper  end  of  the  fibula. 

9 The  lower  end  which  makes  the  outer  ancle, 

10  The  outside  of  the  patella, 

1 1 The  inside  of  the  patella, 

» 


i 


TABLES. 


58 

TABLE  IXT 

1 Astragalus. 

2 Os  calcis. 

3 Os  naviculare. 

4,  5,  6,  Ossa  cuneiformia. 

7 Os  cuboides. 

8 The  five  bones  of  the  metatarsus. 

9 The  two  bones  of  the  great  toe. 

10  The  three  bones  of  the  lesser  toes. 


. 


TAB.X. 


( 


< , 


TABLES. 


59 


TABLE  X, 

A skeleton  of  an  adult  put  into  this  posture  to 
shew  it  in  a greater  scale.  It  was  thought  better 
not  to  figure  it,  all  these  bones  being  explained  in 
former  plates,  and  the  design  of  this  being  to  shew 
them  together,  without  being  defaced  with  refer- 
ences. 


J 


THE 


ANATOMY 

OF  THE 


HUMAN  BODY. 


BOOK  II. 


CHAPTER  L 

INTRODUCTION  TO  THE  MUSCLES. 

The  muscles  are  moving  powers,  applied  to  per- 
form the  several  motions  of  the  body  ; which  they  • 
do  by  contracting  their  length,  and  thereby  bring- 
ing the  parts  to  which  they  are  fixed  nearer  togeth- 
er. The  immoveable  or  least  moved  part  any 
muscle  is  fixed  to,  is  usually  called  its  origin,  and 
the  other  its  insertion  ; but  muscles  that  have  their 
two  ends  equally  liable  to  be  moved,  may  have  ei- 
ther called  the  origins  or  insertions. 

Each  muscle  is  made  up  of  a number  of  small 
fibres,  which  Borelli  and  others  have  thought 


6 -2 


INTRODUCTION 


to  be  strings  of  bladders,  and  have  endeavoured  to 
account  for  muscular  motion  by  an  expansion  made 
from  an  influx  of  blood  and  animal  spirits  into  these 
bladders  ; but  as  the  muscles  do  not  increase  their 
bulk  sensibly  in  contracting,  there  needs  no  more 
to  be  said  to  refute  this  hypothesis.  But  another 
great  author  thought  that  in  this  way  the  muscles 
might  be  contracted  by  a swelling,  scarce  sensible, 
if  the  bladders  were  but  very  small  : for,  says  he, 
supposing  a bladder  of  any  determined  bigness  cs|n 
raise  a weight  a.  foot,  a hundred  bladders,  whose 
diameters  are  each  a hundredth  part  of  the  former, 
will  raise  the  weight  to  the  same  height.  But  the 
force  of  inflation  and  the  swelling  of  all  together 
will  be  ten  thousand  times  less,  and  it  will  also 
raise  ten  thousand  times  less  weight,  which  he 
has  not  observed  ; therefore  not  one  such  string  of 
bladders,  but  ten  thousand,  must  be  applied  to  do 
the  same  thing  that  the  one  bladder  will  do  ; and 
they  will  have  the  same  swelling ; otherwise  it 
would  be  easy  to  shew  how  to  make  a pcrpetuum 
mobile  of  almost  any  force. 

The  muscles  are  of  two  sorts,  viz.  rectilineal, 
and  penniform.  The  former  have  their  fibres  al- 
most parallel,  in  the  same  or  near  the  same  direction 
with  the  axis  of  the  muscle  ; and  the  latter  have 
their  fibres  joined,  in  an  oblique  direction,  to  a ten- 
don passing  in  or  near  the  axis,  or  on  their  outside. 

The  rectilineal  muscles,  if  their  origins  and  in- 
sertions are  in  little  compass,  are  never  of  any  con- 


TO  THE  MUSCLES. 


t*  o 

63 

siderable  thickness,  unless  they  are  very  long,  be- 
cause  the  outer  fibres  would  compress  the  inner 
ones,  and  make  them  almost  useless ; and  therefore 
every  rectilineal  muscle,  whose  inner  fibres  are 
compressed  by  the  outer,  have  their  inner  fibres 
longer  than  the  external,  that  they  may  be  capable 
of  equal  quantity  of  contraction. 

The  penniform  muscles,  though  they  are  in  a 
manner  free  from  the  inconvenience  of  one  fibre 
compressing  another,  and  though  by  the  obliquity 
of  their  fibres,  nothing  is  abated  of  their  moment, 
(for  in  all  cases,  just  so  much  more  weight  as  recti- 
lineal fibres  will  raise  than  oblique  ones,  the  ob- 
lique will  move  their  weight  with  so  much  greater 
velocity  than  the  rectilineal ; which  is  making  their 
moments  equal  : so  that  in  the  structure  of  an  ani- 
mal, like  all  mechanic  engines,  whatever  is  gained 
in  strength  is  lost  in  velocity,  and  whatever  is  gain- 
ed in  velocity  is  lost  in  strength)  yet  the  fibres  of 
the  penniform  muscles  becoming  more  and  more 
oblique  as  they  contract,  their  strength  decreases, 
and  their  velocity  increases,  which  makes  them  less 
uniform  in  their  actions  than  the  rectilineal  mus- 
cles ; wherefore  it  seems  that  nature  never  uses  a 
penniform  muscle  where  a rectilineal  muscle  can 
be  used  ; and  the  cases  in  which*  a rectilineal  mus- 
cle cannot  be  used,  are  where  the  shape  of  a mus- 
cle is  such  as  that  the  inward  fibres  would  be  too 
much  compressed,  or  where  rectilineal  fibres  could 


64 


INTRODUCTION* 


not  have  a lever  to  act  with,  suitable  to  their  quan- 
tity of  contraction,  which  is  the  case  of  all  the 
long  muscles  of  the  fingers  and  toes.  For  every 
muscle  must  be  inserted  or  pass  over  the  centre 
of  motion  of  the  joint  it  moves,  at  a distance, 
suitable  to  its  quantity  of  contraction,  and  the 
quantity  of  motion  in  the  joint  moved  ; for  if  it 
was  inserted  too  near,  then  the  motion  of  the  joint 
would  be  performed  before  the  muscle  is  contract- 
ed all  that  it  can ; if  too  far  off,  the  muscle  will 
have  done  contracting  before  the  whole  motion  of 
the  joint  is  made.  And  though  the  quickness  and 
quantity  of  mot-ion  in  a muscle  will  be,  cseteris  pa- 
ribus, as  the  length  of  its  fibres  ; (for  if  a fibre  four 
inches  long  will  contract  one  inch  in  a given  time, 
a fibre  eight  inches  long  will  contract  two  inches 
in  the  same  time ; and  the  strength  of  a muscle 
or  power  to  raise  a weight,  cseteris  paribus,  will 
be  as  the  number  of  its  fibres  ; for  if  one  fibre 
will  raise  a grain  weight,  twenty  fibres  will  raise 
twenty  grains  :)  nevertheless,  two  muscles  of 
equal  magnitude,  one  long,  and  the  other  short, 
will  both  move  the  same  weight  with  the  same  ve- 
locity when  applied  to  a bone  ; because  the  levers 
they  act  with  must  be  as  their  lengths,  and  there- 
fore the  penniform  and  short  thick  muscles  are 
never  applied  to  a bone  for  the  sake  of  strength,  nor 
long  fibred  muscles  for  quickness  ; for  whatever  is 
gained  by  the  form  of  the  muscle,  whether  strength 
or  quickness,  must  be  lost  by  their  insertions  into 


TO  TH£  MUSCLES. 


65 


the  bone,  or  else  the  muscles  must  not  act  all  they 
can,  or  the  bones  have  less  motion  than  they  are 
made  for. 

In  the  limbs  several  muscles  pass  over  two 
joints,  both  of  which  are  liable  to  move  at  once, 
with  force  proportionable  to  the  levers  they  act 
with  upon  each  joint ; but  either  joint  being  fixed 
by  an  antagonist  muscle,  the  whole  force  of  such 
muscles  will  be  exerted  upon  the  other  joint  ; 
which  in  that  case  may  be  moved  with  a velocity 
equal  to  what  is  in  both  joints,  when  these  muscles 
act  upon  both  at  once.  This  mechanism  is  of 
great  use  in  the  limbs,  as  I shall  shew  in  the  prop- 
er places. 

That  only  we  call  the  proper  use  and  action 
of  any  muscle  which  it  has  without  the  necessary 
assistance  of  any  other  muscle,  and  what  that  is 
in  a muscle  moving  a joint  we  may  always  know 
in  any  situation,  and  with  what  force  it  acts,  cae- 
teris  paribus,  by  dropping  a line,  from  the  centre 
of  motion  of  the  joint  it  moves,  perpendicular  into 
the  axis  of  the  muscle  ; but  in  a joint  which  ad- 
mits only  of  flection  and  extension,  this  line  must 
also  be  perpendicular  to  the  axis  of  motion  in  that 
joint,  and  the  action  of  the  muscles  will  be  in  the 
direction  of  that  perpendicular  line,  and  the  force 
with  which  it  acts  in  any  situation  will  be,  caeteris 
paribus,  as  the  length  of  that  perpendicular  line. 

Each  muscle,  so  far  as  it  is  distinct,  and  is  moved 
against  any  part,  is  covered  with  a smooth  mem- 


66 


INTRODUCTION,  &C. 

brane  to  make  the  friction  easy  ; but  where  they 
are  externally  tendinous,  those  tendons  are  often 
smooth  enough  to  make  such  a covering  needless. 
Besides  this  membrane  there  is  another,  known  by 
the  name  of  fascia  tendinosa,  which  deserves  to  be 
particularly  considered.  The  strong  one  on  the 
outside  of  the  thigh,  which  belongs  to  the  fascialis 
and  gluteus  muscles,  is  of  great  use  in  raising  the 
gluteous  farther  from  the  centre  of  motion  of  the 
joint  it  moves,  to  increase  its  force  : in  like  manner 
the  fascia  detached  from  the  tendon  of  the  biceps 
cubiti  alters  its  directions  for  the  same  purpose,  but 
those  on  the  outside  of  the  tibia  and  cubit,  &c.  are 
only  flat  tendons  from  which  the  fibres  of  the 
muscles  arise  as  from  the  bones.  There  are  also 
in  many  places  such  tendons  between  the  muscles, 
from  which  each  muscle  arises  in  like  manner  ; for 
the  bones  themselves  are  not  sufficient  to  give 
origin  to  half  the  fibres  of  the  muscles  that  belong 
to  them ; besides,  if  all  the  fibres  had  rise  from 
the  bones,  they  must  have  been  liable  to  compress 
one  another  very  inconveniently. 


OF  THE  MUSCLES. 


67 


CHAPTER  II. 

OF  THE  MUSCLES. 

OBLIQUUS  descendens  arises  fleshly  from  near 
the  extremities  of  the  eight  inferior  ribs,  the 
upper  part  of  its  origin  being  indented  with 
the  seratus  major  anticus,  and  the  lower  lying 
under  a small  portion  of  the  latissimus  dorsi. 
It  is  inserted  fleshly  into  the  upper  part  of  the  spine 
of  the  ilium,  and  by  a broad  flat  tendon,  (which 
firmly  adheres  to  a like  tendon  of  the  following 
muscle  as  they  pass  over  the  rectus)  into  the  os 
pubis,  and  linea  alba,  which  is  a strong  tendinous 
line  extended  from  the  os  pubis  to  the  sternum, 
between  the  musculi  recti. 

Obliquus  ascendens  arises  fleshly  under  the 
former  muscle  from  the  spine  of  the  ilium,  and  is 
inserted  fleshly  in  the  cartilages  of  the  three  lowest 
ribs,  and  by  a flat  tendon  into  the  sternum,  and 
linea  alba,  together  with  the  tendon  of  the  forego- 
ing muscle.  The  line  in  which  these  two  tendons 
join  on  the  outside  of  the  rectus  muscle,  is  called 
semilunaris : and  though  so  much  of  this  muscle 
as  is  inserted  fleshly  runs  obliquely  upward,  yet  the 
middle  and  lower  part  is  directed  transverse  and 
downward ; and  beside  the  tendon,  which  it  unites 
with  the  obliquus  descendens,  it  often  detaches 
another  near  the  sternum  to  be  inserted  with  the 
transversalis  under  the  rectus. 


68 


OF  THE  MUSCLES, 


Pyramidalis  arises  from  the  os  pubis,  and  is 
inserted  into  the  linea  alba,  about  three  or  four 
inches  below  the  navel : this  and  its  fellow  are 
often  wanting. 

Rectus  arises  tendinous  from  the  os  pubis,  but 
fleshy  when  the  pyramidales  are  wanting,  and  is 
inserted  into  the  lower  part  of  the  sternum,  near 
the  cartilago  ensiformis.  This  muscle  is  divided 
into  four  or  five  portions  by  transverse  tendinous 
intersections,  that  it  might  conveniently'  bend  when 
the  body  is  bowed  forwards,  though  this  muscle 
should  be  then  in  action  ; and  these  intersections 
are  chiefly  above  the  navel,  where  it  is  most  liable 
to  be  bent : besides,  being  thus  divided,  its  chief 
pressure  will  not  be  in  its  middle,  but  under  the 
several  bellies  of  the  muscle,  and  the  greatest  below 
the  navel,  where  is  the  longest  fleshy  belly  of  this 
muscle,  and  where  the  parts  in  the  abdomen  seem 
to  want  most  to  be  supported. 

Transversalis  arises  by  a flat  tendon  from  the 
transverse  processes  of  the  lumbal  vertebrae,  and 
fleshy  from  the  inside  of  the  ribs  below  the  diar 
phragm,  and  from  the  spine  of  the  ilium  ; then, 
becoming  a flat  tendon,  it  passes  under  the  rectus 
to  its  insertion  into  the  linea  alba.  Between  this 
tendon  and  the  peritoneum  sometimes  water  is 
found  in  great  quantities,  which  distemper  is 
called  the  dropsy  in  the  duplicature  of  the  peri- 
toneum ; which  shews  this  membrane  has  been 
mistaken  for  part  of  the  peritoneum. 


OF  THE  MUSCLES. 


69 


These  five  pair  of  muscles  all  conspire  to 
compress  the  parts  contained  in  the  abdomen. 
The  obliquus  descendens  on  the  right  side,  and 
ascendens  on  the  left  acting  together,  turn  the 
upper  part  of  the  trunk  of  the  body  towards  the 
left,  and  vice  versa  ; but  the  trunk  is  chiefly 
turned  upon  the  thighs  ; the  recti  bend  the  body 
forward,  and  pull  the  sternum  downward  in  ex- 
piration ; the  two  oblique  muscles  and  the  trans- 
verse on  each  side  near  the  groin,  are  perforated 
to  let  through  the  processus  vaginalis  with  the 
spermatic  vessels.  These  perforations  are  distant 
from  each  other,  so  as  to  suffer  the  vessels  to 
descend  conveniently  into  the  scrotum : this  way 
the  intestines  or  the  omentum  descend  in  rup- 
tures. 

Cremaster  testis  is  a small  portion  of  fibres 
which  arises  from  the  ilium,  and  appears  to 
be  part  of  the  obliquus  ascendens  muscle,  till  it 
meets  with  the  spermatic  vessels  at  their  coming 
out  of  the  abdomen,  where  it  begins  to  descend 
with  them  by  the  side  of  the  processus  vaginalis, 
to  the  testicle,  over  which  it  is  loosely  expanded. 
This  muscle  is  too  small  to  be  plainly  discovered 
in  emaciated  bodies. 

Erector  penis  arises  from  the  os  ischium,  and 
is  inserted  into  the  crus  penis  near  the  os  pubis. 
It  is  said,  by  pressing  the  penis  against  the  os  pubis 
to  compress  the  vena  ipsius  penis,  and  hinder  the 
reflux  of  blood,  whereby  the  penis  becomes  ex- 


70 


OF  THE  MUSCLES. 


tended  and  erect  : but  it  does  not  appear  to  me  to 
be  well  contrived  for  that  use. 

Accelerator  urinas.  This,  with  its  fellow, 
are  but  one  muscle.  It  arises  tendinous  from  the 
ossa  ischia,  and  fleshy  from  the  sphincter  ani  j or, 
according  to  Mr.  Cowper,  from  the  superior  part 
of  the  urethra  as  it  passes  under 'the  os  pubis  : and 
thence  being  expanded  over  the  bulb  of  the 
urethra,  it  afterwards  divides,  and  is  inserted  into 
the  penis.  The  use  of  this  muscle  is  not  to  acceL 
erate  the  urine,  for  that  is  propelled  by  the  detrusor 
urinas,  or  muscular  coat  of  the  bladder,  but  to  pro- 
trude the  semen,  which  is  done  only  by  this  : and 
it  being  seated  opposite  to  the  os  pubis,  it  seems  to 
be  much  better  fitted  to  be  a relaxer  of  the  penis, 
by  pulling  it  from  the  os  pubis,  than  the  erector  is 
for  the  office  assigned  it. 

Transversalis  penis  is  that  part  of  the  former 
muscle  which  arises  from  the  ossa  ischia. 

Sphincter  vesicas  urinariae  is  a small  portion  of 
muscular  fibres,  not  easily  to  be  distinguished,  run- 
ning round  the  neck  of  the  bladder  to  prevent  the 
involuntary  effusion  of  urine. 

Detrusor  urinae  is  the  muscular  coat  of  the  blad- 
der ; its  fibres  are  differently  disposed ; but  chiefly 
terminating  in  the  sphincter  vesica,  whereby  it  not 
only  presses  the  urine  forward,  but,  when  the  blad- 
der is  full,  becomes  an  antagonist  to  the  sphincter, 
acting  almost  at  right  angles. 


OF  THE  MUSCLES. 


71 


Erector  clitoridis  arises  from  the  ischium,  and 
is  inserted  into  the  crus  clitoridis,  like  the  erector 
penis  in  men,  and  is  said  to  cause  erection  in  the 
same  manner. 

Sphincter  vaginas  is  an  order  of  muscular  fi- 
bres, intermixed  with  membranous  fibres,  surround- 
ing the  vagina  uteri  near  its  orifice  ; it  is  connect- 
ed to  the  ossa  pubis  and  sphincter  ani ; its  use  is 
to  constringe  the  orifice  of  the  vagina,  to  press  out 
a liquor  from  the  glands  of  the  vagina,  and  em- 
brace the  penis  in  coition. 

Dr.  Douglas  mentions  two  pair  of  muscles  of 
the  vagina,  of  his  own  discovering,  which  I have 
never  dissected,  and  will  therefore  give  them  in  his 
own  words  ; “ The  first  arises  from  the  inner  edge 
of  the  os  pubis  midway  between  the  ischion  and 
the  beginning  of  the  crus  clitoridis,  is  inserted  in- 
to the  vagina ; the  second  arises  tendinous  and 
fleshy  from  the  os  pubis  internally  in  common 
with  the  levator  ani,  is  inserted  into  the  upper 
part  of  the  vagina  at  the  side  of  the  meatus  urina- 
rius  or  collum  vesica.” 

“ Sphincter  ani  is  a muscle  near  two  inches  in 
breadth,  surrounding  the  anus  to  close  it,  and  to 
prevent  involuntary  falling  out  of  the  feces. 

Levator  ani,  by  Dr.  Douglas  called  two 
pair  of  muscles,  but  Mr.  Cowper  describes  the 
whole  as  one  muscle  only,  which  arises  from  the 
ossa  ischii,  pubis,  and  sacrum  within  the  pelvis,  and 
is  inserted  round  the  lower  end  of  the  rectum  in- 
testinum. 


OF  THE  MUSCLES. 


72 

Fistulee  in  ano,  that  arc  within  this  muscle* 
generally  run  in  the  direction  of  the  gut,  and  may 
be  laid  open  into  the  gut  with  great  safety  ; but 
those  fistula;,  or  rather  abscesses,  that  are  frequently 
formed  on  the  outside  of  the  sphincter,  and  usually 
surround  it,  all  but  where  this  muscle  is  connected 
to  the  penis,  cannot  be  opened  far  into  the  gut, 
without  totally  dividing  the  sphincter,  which,  au- 
thors say,  renders  the  sphincter  ever  after  incapable 
of  retaining  the  excrement.  One  instance  of  this 
kind  I have  known  ; but  Mr.  Berbeck  of  York,  an 
excellent  surgeon,  and  particularly  famous  for  this 
operation,  has  assured  me,  that  he  has  often  been 
forced  to  divide  the  sphincter,  which  has  made  the 
patients  unable  to  hold  their  excrements  during 
their  cure,  but  the  wounds  being  healed,  they  have 
retained  them  as  well  as  ever. 

Coccygei  arise  from  the  acute  processes  of  the 
ossa  ischii,  and  are  inserted  into  the  os  coccygis, 
which  they  pull  forward. 

Occipito-frontalis,  is  a muscle  with  four  fleshy 
bellies,  commonly  named  frontales  and  occipi- 
tales.  It  arises  behind  each  ear  from  the  os  oc- 
cipitis,  and  soon  becoming  tendinous,  passes  un- 
der the  hairy  scalp  to  the  forehead,  where  it  be- 
comes broad  and  fleshy,  adhering  to  the  skin,  and  is 
inserted  into  the  upper  part  of  the  orbicular  muscles 
of  the  eyelids,  into  the  os  frontis  near  the  nose,  and 
by  two  processes  into  the  bones  of  the  nose.  When 
this  muscle  acts  from  the  back  part  it  pulls  the 


OF  THE  MUSCLES. 


skin  of  the  forehead  up\tafd,  and  wrinkles  it  trans-1 
verse,  and  in  some  persons  the  hairy  scalp  back-* 
wards  ; but  when  the  fore  part  of  it  acts,  it  draws 
the  skin  with  the  eyebrows  downward,  and  towards 
the  nose  when  we  frown.  The  tendon  of  this  mas* 
cle  has  been  mistaken  for  a membrane,  and  been 
called  pericranium,  and  the  true  pericranium,  pe- 
riosteum. 

Elevator  auricula;  arises  from  the  tendon  of 
the  occipito-frontalis,  and  is  inserted  into  the 
upper  part  of  the  ear  that  is  connected  to  the 
head. 

Retractor  auricula;  arises  by  one,  two,  or 
three  small  portions  from  the  temporal  bone  above 
the  mammillary  process,  and  is  inserted  into  the  ear 
to  pull  it  backward. 

Orbicularis  palpebrarum  surrounds  the  eye- 
lids on  the  edge  of  the  orbit,  and  is  fixed  to  the 
sutura  transversalis  at  the  great  corner  of  the  eye  ; 
it  fliuts  the  eyelids,  especially  in  winking.  That 
part  of  this  muscle  that  lies  under  the  eyebrow  is 
very  much  intermixed  with  the  occipito-frontalis  ; 
and  under  it,  from  the  os  frontis  near  the  nose-, 
arises  a small  portion  of  distinct  fibres  which  end  in 
this  muscle,  and,  I think,  are  a part  of  it  ; neverthe- 
less, from  the  effect  of  their  action,  are  not  improp- 
erly called  musculus  corrugator. 

Ciliaris  is  a very  small  portion  of  this  muscle, 
next  the  ciliary  cartilages  of  the  eyelids. 


L 


74 


OF  THE  MUSCLES. 


Elevator  palpebrse  superioris  rectus  rises  above 
the  optic  nerve,  from  the  periosteum  at  the  bot- 
tom of  the  orbit,  as  do  also  the  five  following 
muscles,  and  is  inserted  into  the  whole  ciliary- 
cartilage  of  the  upper  eyelid  by  a very  thin  flat 
tendon. 

Elevator  oculi  arises  from  the  bottom  of  the 
orbit,  between  the  optic  nerve  and  the  foregoing 
muscle,  and  is  inserted  in  the  upper  part  of  the  tu- 
nica sclerotis  of  the  eye,  near  the  cornea. 

Depressor  oculi  arises,  and  is  inserted  directly 
opposite  the  last  described  muscle. 

Adductor  oculi  arises  from  the  bottom  of  the 
orbit,  near  the  optic  nerve  internally,  and  is  in- 
serted into  the  tunica  sclerotis  on  the  side  next 
the  nose. 

Abductor  oculi  has  both  its  origin  and  inser- 
tion directly  opposite  to  the  adductor. 

Obliquus  superior  seu  trochlearis  arises  between 
the  elevator  and  adductor  oculi  at  the  bottom 
of  the  orbit,  thence  ascending  by  the  sutura  trans- 
versalis,  becomes  a round  tendon,  which  palling 
through  a pulley  at  the  upper  and  inner  part  of  the 
orbit  near  its  edge,  is  inserted  near  the  bottom  of 
the  globe  of  the  eye,  which  it  pulls  upward  and 
inward,  and  thereby  directs  the  pupil  outward  and 
downward. 

Obliquus  inferior  arises  from  the  os  maxil- 
lae superioris,  at  the  edge  of  the  orbit  ; thence 
passing  over  the  depressor  is  inserted  near  the  ab- 


OF  THE  MUSCLES. 


75 


ductor  at  the  bottom  of  the  eye  ; but  not  so  low 
as  the  insertion  of  the  obliquus  superior  : it  turns 
the  pupil  upward  and  outward. 

These  muscles  are  inserted  with  great  advan- 
tage to  move  a small  weight,  and  are  very  long, 
that  the  eye  may  be  moved  with  sufficient  quick- 
ness. The  two  oblique  muscles  are  an  axis  to  the 
motions  of  the  other  four,  and  acting  strongly 
against  them,  which  action  I take  to  be  what  is 
vulgarly  called  straining  the  eye,  may,  I think, 
bring  the  crystalline  humour  nearer  to  the  retina, 
and  possibly  may  make  the  crystalline  humour 
more  flat  to  fit  the  eye  for  objects  at  a great  dis- 
tance. For  this  end  it  seems  to  me  that  there  are 
six  muscles  thus  disposed,  when  three  might  be 
sufficient  to  turn  the  eye  every  way,  if  it  was  in  a 
proper  fixed  socket  : and  it  seems  also,  that  while 
the  muscles  are  all  thus  in  action,  the  superior  ob- 
lique in  each  eye  sets  the  pupil  farther  from  the 
nose,  while  the  inferior  oblique  directs  it  upward  ; 
the  first  of  which  actions  is  always  necessary,  and 
the  latter  often  so,  when  we  look  with  both  eyes 
at  very  distant  objects  ; and  when  the  two  oblique 
muscles  grow  weak  by  age  or  disease,  or  cease  to 
act  at  all,  as  in  paralytic  cases,  and  death,  then  the 
eye  sinks  in  the  orbit. 

Sphincter,  or  constrictor  oris,  surrounds  the 
mouth  about  three  fourths  of  an  inch  broad.  This 
muscle  is  very  much  intermixed  with  all  the  mus- 
cles that  are  inserted  into  it. 


76 


OF  THE  MUSCLES. 


Elevator  labii  superioris  proprius  arises  from 
the  bone  of  the  upper  jaw  under  the  anterior  and 
inferior  part  of  the  orbicularis  palpebrarum,  and 
usually  takes  another  small  beginning  from  the  os 
malae,  which  seems  as  if  it  was  sent  off  from  the 
orbicularis  palpebrarum  ; and  passing  down  by  the 
side  of  the  nose,  into  which  it  sends  some  fibres,  is 
inserted  into  the  upper  part  of  the  sphincter  oris. 
This  raises  the  upper  lip,  and  helps  to  dilate  the 
nostrils, 

Depressor  labii  superioris  proprius  is  a small 
muscle  arising  from  the  upper  jaw,  near  the  dentes 
incisorii,  and  is  inserted  into  the  upper  part  of  the 
lip  and  root  of  the  cartilages  of  the  nose  ; hence  it 
is  also  a depressor  of  the  nose,  which  action  con- 
stricts the  nostrils. 

Depressor  labii  inferioris  proprius  arises  broad 
from  the  lower  jaw  at  the  chin,  and  is  soon  insert- 
ed into  the  sphincter  oris ; the  order  of  fibres  in 
this  seems  not  so  conspicuous  as  in  the  other  mus- 
cles of  the  face. 

Elevator  labii  inferioris  proprius  arises  from  the 
lower  jaw,  near  the  dentes  incisorii,  and  is  insert- 
ed into  the  lower  part  of  the  lip. 

Elevator  labiorum  communis  arises  from  a de- 
pressed part  of  the  superior  maxilla  under  the  mid- 
dle of  the  orbit,  and  is  inserted  into  the  sphincter 
muscle  near  the  corner  of  the  mouth. 

Depressor  communis  labiorum  arises  later- 
ally from  the  lower  jaw  near  the  chin,  and  Is 


or  THE  MUSCLES.  77 

inserted  into  the  sphincter  opposite  to  the  for- 
mer. 

Zygomaticus  arises  from  the  anterior  part  of 
the  os  zygoma  or  malae,  and  frequently  derives  a 
portion  of  fibres  from  the  orbicularis  palpebrarum., 
thence  running  obliquely  downwards.  It  is  inserted 
into  the  sphincter  at  the  corner  of  the  mouth,  be- 
twixt the  elevator  communis  and  buccinator  ; It 
draws  the  corner  of  the  mouth  outward  and  upward. 
When  this  muscle  grows  weak,  the  corner  of  the 
mouth  sinks,  as  may  be  observed  in  old  persons. 

Buccinator  arises  from  the  processus  coronas 
of  the  lower  jaw,  and  passing  contiguous  to  both 
jaws,  is  inserted  into  the  sphincter  muscle  at  the 
corner  of  the  mouth.  It  serves  either  to  force 
breath  out  of  the  mouth,  or  thrust  the  aliment 
between  the  teeth  in  mastication,  or  to  pull  the 
corner  of  the  mouth  outward. 

Platysma  myoides  arises  loosely  from  over  the 
pectoral  and  part  of  the  deltoid  muscle,  and  run- 
ning obliquely  forward,  is  inserted  into  the  chin, 
and  depressor  muscles  of  the  lips.  This  muscle 
being  exceeding  thin,  a mere  membrana  carno- 
sa,  serves  to  cover  the  unequal  surface  of  the 
subjacent  muscles,  and  render  the  neck  even  ; it 
also  pulls  down  the  corner  of  the  mouth,  and,  from 
its  insertion  at  the  chin,  may  contribute  to  the  pull- 
ing down  of  the  lower  jaw. 

Retractor  alas  nasi  is  a very  small  muscle  aris- 
ing from  the  bone  of  the  nose,  and  is  inserted 


78  or  THE  MUSCLES. 

into  the  skin  and  cartilage  at  the  side  of  the 
nose. 

Mylohyoideus  with  its  fellow  may  be  esteem- 
ed one  penniform  or  else  a digastric  muscle.  It 
arises  from  the  linea  aspera  on  the  inside  of  the 
lower  jaw  and  processus  innominatus,  both  sides 
meeting  at  about  right  angles  in  a middle  line  upon 
the  following  muscles.  It  is  inserted  by  a small 
portion  of  fibres  into  the  basis  of  the  os  hyoides  ; 
it  moves  the  tongue  upward  and  forward,  and  also 
compresses  the  following  muscles,  whereby  they 
raise  the  tongue  more  commodiously,  and  also  hin- 
ders them  from  drawing  the  basis  of  the  os  hyoi- 
des into  a right  line  betwixt  the  chin  and  sternum 
at  such  times  as  the  stylohyoidei  cannot  act. 

Geniohyoideus  arises  from  the  processus  in- 
nominatus of  the  lower  jaw,  under  the  foregoing 
muscle,  and  is  inserted  into  the  basis  of  the  os  hy- 
oides which  it  pulls  upward  and  forward.  This, 
with  its  fellow,  are  for  the  most  part  but  one 
muscle. 

Stylohyoideus  arises  from  the  processus  styli- 
formis,  near  its  root,  and  passing  contiguous  to  the 
horn  of  the  os  hyoides  becomes  inserted  laterally 
into  its  basis.  This  muscle  is  sometimes  perforated 
about  the  middle,  by  the  tendon  of  the  digastric 
muscle  of  the  lower  jaw.  Its  use  is  to  pull  the  os 
hyoides  up  and  backward. 

Coracohyoideus  arises  from  the  upper  costa 
of  the  scapula,  near  the  processus  coracoides,  and 


OF  THE  MUSCLES.  79 

passing  under  the  mastoideus  muscle  becomes  in 
that  place  a round  tendon ; thence  passing  almost 
parallel  to  the  following  muscle,  is  inserted  togeth- 
er with  it  into  the  basis  of  the  os  hyoides  ; this 
draws  the  os  hyoides  downward,  and  a little  back- 
ward. I have  once  seen  one  of  these  muscles  want- 
ing, and  the  sternohyoideus  arising  from  the  mid- 
dle of  the  clavicle  on  that  side. 

Sternohyoideus  arises  from  a roughness  at  the 
under  part  of  the  clavicula  near  the  sternum, 
and  the  cartilaginous  part  of  the  first  rib  ; and  is 
inserted  into  the  basis  of  the  os  hyoides,  to  pull  it 
downward. 

Genioglossus  arises  from  the  processus  innom- 
inatus  of  the  lower  jaw,  and  is  inserted  broad 
into  the  under  part  of  the  tongue,  to  pull  it  up  and 
forward,  and  sometimes  has  a small  insertion  into 
the  os  hyoides. 

Basioglossus  seems  a portion  of  the  former  mus- 
cle ; it  arises  from  the  basis  of  the  os  hyoides,  and 
is  inserted  into  the  tongue  nearer  its  tip. 

Ceratoglossus  arises  from  the  horn  of  the  os  hy- 
oides, and  is  laterally  inserted  into  the  tongue 
near  its  root,  to  pull  it  downward  and  forward. 

Styloglossus  arises  from  the  extremity  of  the 
processus  styliformis,  and  is  inserted  into  the  tongue 
near  the  former  to  pull  it  up  and  backward.  I 
have  very  often  found  another  styloid  muscle  so  in- 
serted, that  I cannot  tell  whether  to  call  it  a muscle 
of  the  tongue  or  pharynx. 


80 


oe  thc  jftrsdtrSr 


The  tongue  is  a muscle  made  of  fibres,  Ion* 
gitudinal,  circular,  and  transverse,  so  intermixed  as 
best  to  serve  its  several  motions. 

Hypothyroideus  or  Ceratothyroideus,  arises  from 
part  of  the  basis,  and  the  horn  of  the  os  hy- 
oides,  and  is  inserted  into  the  lower  part  of  the 
cartilago  thyroides,  to  pull  it  forward. 

Sternothyroideus  arises  from  the  inside  of  the 
sternum,  and  is  inserted  with  the  former  ; it  pulls* 
the  thyroid  cartilage  directly  downward. 

Cricothyroideus  arises  from  the  anterior  part 
or  the  cartilago  cricoides,  and  running  obliquely  up- 
ward and  outward,  is  soon  inserted  into  the  inside 
of  the  cartilago  thyroides,  which  it  pulls  towards 
the  cartilago  cricoides.  Both  this  muscle  and  its 
fellow  for  the  most  part  appear  double. 

Cricoarytsenoideus  posticus  arises  from  the  back 
part  of  the  cartilago  cricoides,  and  is  inserted  into 
the  arytsenoides  to  pull  it  backward. 

Cricoarytsenoideus  lateralis  arises  laterally  from 
the  cartilago  cricoides,  and  is  inserted  laterally  into 
the  arytsenoides.  This,  with  its  fellow,  pull  down 
each  cartilage  toward  their  origin,  and  thereby 
dilate  the  rimula. 

Thyroarytsenoideus  arises  from  the  superior, 
middle,  and  inner  part  of  the  cartilago  thyroides, 
and  is  inserted  with  the  former  into  the  ary- 
taenoides  cartilaere  to  dilate  the  rimula.  These 
two  last  described  muscles  are  not  naturally  divided, 
and  therefore  ought  to  be  accounted  but  one  muscle. 


of  The  muscles. 


§1 


Arytsenoideus  is  one  single  muscle,  which  arises 
from  one  arytsenoidal  cartilage,  and  is  inserted  in- 
to the  other,  to  draw  them  together,  and  close  the 
rimula.  These  few  small  muscles  of  the  tongue 
and  larynx,  with  only  one  pipe,  make  a great  va- 
riety of  notes  and  sounds  that  can  be  made  by  ar- 
tificial instruments,  and  that  in  a manner  so  little 
understood  by  us,  and  by  organs  so  little  differing 
from  those  in  quadrupeds,  that,  for  aught  we  know 
of  them,  brutes  might  be  as  capable  of  all  these 
sounds  as  men. 

Stylopharyngseus  arises  from  near  the  bottom 
of  the  processus  styloides  of  the  os  petrosum, 
and  running  obliquely  downward,  is  insert- 
ed into  the  pharynx.  This  muscle,  with  its 
fellow,  pulls  up  and  dilates  the  pharynx  to  receive 
the  aliment. 

CEsophageus  arises  like  a wing  from  several 
parts  of  the  scull,  tongue,  os  hyoides,  the  cricoid 
and  thyroid  cartilages,  and  is  inserted  into  the 
pharynx.  This,  with  its  fellow,  constringes  the 
pharynx,  and  presses  the  aliment  down  the  gullet. 

Musculus  vaginalis  guise  is  the  muscular  coat  of 
the  gula. 

Pterygopharyngseus  is  not  a distinct  muscle, 
but  the  beginning  of  the  pharynx  near  the  pro- 
cessus pterygoides  of  the  sphenoidal  bone. 

Pterygostaphylinus  internus  arises  from  the 
os  sphenoides,  near  the  iter  ad  palatum,  or 
eustachian  tube,  and  is  inserted  into  the  uvula. 


M 


82 


OF  THE  MUSCLES. 


which  it  pulls  up  while  we  breathe  through  the 
mouth,  or  swallow. 

Pterygo-staphylinus  externus  arises  by  the 
side  of  the  last  described  muscle,  and  is  also  in- 
serted near  it  ; but  becomes  its  antagonist  by  be- 
ing reflected  on  a pulley,  over  a process  at  the 
lower  part  of  the  pterygoidal  processes  of  the  sphe- 
noidal bone. 

Glosso-staphylinus  is  a very  small  portion  of 
muscular  fibres,  which  pass  from  the  tongue  to 
the  palate,  which  it  pulls  down  when  we  breathe 
through  the  nose. 

The  palate  itself  is  a sort  of  double  muscle, 
whose  action  seems  only  to  support  itself,  and  assist 
those  muscles  which  pull  it  upwards. 

Digastricus  arises  from  sinus  of  the  mammil- 
lary process  of  the  os  temporis,  and,  from  a fleshy 
belly  becoming  a round  tendon,  passes  through, 
and  sometimes  under,  the  stylohyoideus  muscle  ; 
and  then,  being  tied  down  by  a ligament  to  the  os 
hyoides,  grows  fleshy,  and  is  so  inserted  into  the 
anterior  part  of  the  lower  jaw  internally.  This 
muscle’s  direction  being  altered  by  its  being  tied  to 
the  os  hyoides,  where  it  makes  an  angle,  and  not 
at  its  passage  through  the  stylohyoideus,  pulls  the 
lower  jaw  downward  with  much  greater  force 
than  otherwise  it  could  have  done  ; and  being  con- 
nected to  the  os  hyoides,  when  it  acts,  it  prevents 
the  action  of  several  muscles  which  are  concerned 
in  swallowing ; whence  it  is  that  we  cannot  swal- 


OF  THE  MUSCLES. 


83 


iow  at  the  same  time  that  we  open  the  jaw,  as 
those  brutes  can  whose  digastric  muscles  are  not 
connected  to  that  bone. 

Temporalis  arises  from  the  os  frontis,  parie- 
tale,  sphenoides,  malse,  and  temporis,  and,  passing 
under  the  two  processes  named  os  jugale,  is  inserted 
externally  into  the  processus  coronalis  of  the  lower 
jaw,  which  it  pulls  upward.  This  muscle  is  covered 
with  a strong  tendinous  fascia. 

Masseter  arises  from  the  lower  edge  of  the 
os  malse  or  zygoma,  and  the  process  which  joins 
this  from  the  temporal  bone,  and  is  inserted  into  the 
outer  part  of  the  angle  of  the  lower  jaw,  which  it 
pulls  up  and  forward.  These  two  last  described 
muscles  having  different  directions,  when  they  act 
together,  make  a steady  motion  in  the  diagonal  of 
their  directions. 

Pterygoideus  interims  arises  from  the  pro- 
cessus pterygoideus  externus,  and  from  the  sinus 
between  the  pterygoid  processes,  and  is  inserted 
internally  into  the  angle  of  the  lower  jaw,  which 
it  pulls  upward. 

Pterygoideus  externus  arises  from  the  os  max- 
illare  and  os  sphenoides,  near  the  root  of  the  exter- 
nal pterygoid  process,  and  is  inserted  internally 
into  the  processus  condyloides  of  the  lower  jaw, 
which  it  pulls  to  one  side,  and  forwards,  or  acting 
with  its  fellow  pulls  the  jaw  directly  forward. 

Subclavius  arises  from  the  superior  part  of  the 
first  rib,  and  is  inserted  into  more  than  half  the 


84 


OF  THE  MUSCLES. 


underside  of  the  clavicula  next  the  scapula.  Its  use 
is  to  draw  the  clavicula  toward  the  sternum,  that 
they  may  not  be  severed  in  the  motions  of  the 
scapula. 

Trapezius  arises  from  the  os  occipitis,  and 
from  a linea  alba  colli,  from  the  spinal  process  of 
the  last  vertebra  of  the  neck,  and  the  ten  upper- 
most of  the  back,  and  from  a linea  alba  between 
all  these  processes  ; and  is  inserted  into  one  third  of 
the  clavicle  next  the  scapula,  almost  all  the  back 
part  of  the  spine  of  the  scapula,  and  as  much  of 
the  processus  acromion  as  lies  between  the  spine  of 
the  scapula  and  the  clavicle.  This  muscle  draws  the 
scapula  directly  backward. 

It  is  generally  said  by  authors,  that  the  several 
parts  of  this  muscle  act  at  different  times,  and  so 
pull  the  scapula  different  ways,  as  obliquely  up- 
ward,  downward,  or  backward  ; but,  I think,  if 
that  happened,  it  must  necessarily  divide  this  mus- 
cle into  distinct  portions,  those  that  contract  always 
separating  from  those  that  do  not. 

Rhomboides  arises  tendinous  under  the  former 
from  the  spinal  process  of  the  inferior  vertebra  of 
the  neck,  part  of  the  linea  alba  colli,  and  from  the 
spinal  processes  of  the  four  or  five  uppermost  ver- 
tebrae of  the  thorax,  and  is  inserted  into  the  basis 
of  the  scapula,  which  it  pulls  up  and  backward. 
The  upper  part  of  this  muscle  arising  from  the 
neck,  is,  in  many  bodies,  by  the  motions  of  the 
neck,  separated  and  made  a distinct  muscle. 


OF  THE  MUSCLES. 


85 


Elevator  scapulae  arises  from  the  transverse 
processes  of  the  four  superior  vertebrae  of  the 
neck,  and  is  inserted  into  the  upper  angle  of  the 
scapula. 

Serratus  minor  anticus  arises  under  the  pecto- 
ralis,  from  the  third,  fourth,  and  fifth  ribs,  and 
is  inserted  into  the  processus  coracoides  scapu- 
lae, which  it  pulls  forward  and  downward.  This 
muscle  is  always  said  to  be  an  elevator  of  the  ribs, 
though  it  arises  from  the  scapula,  which  is  sup- 
ported by  the  ribs. 

Serratus  major  anticus  arises  from  the  anterior 
part  of  the  eight  superior  ribs,  and  is  inserted 
into  the  basis  of  the  scapula,  which  is  draws  for- 
ward, and  by  that  means  moves  the  socket  of  the 
scapula  upward.  This  muscle  has  been  always 
accounted  an  elevator  costarum,  though  each  por- 
tion of  it  is  nearly  parallel  to  the  rib  it  rises  from. 

All  the  muscles  inserted  into  the  basis  of  the 
scapula  are  also  inserted  into  one  another. 

Pectoralis  arises  from  near  two  thirds  of  the 
clavicula,  next  the  sternum,  and  all  the  length  of 
the  os  pectoris,  and  from  the  cartilages  of  the  ribs, 
and  is  inserted  into  the  os  humeri,  between  the  bi- 
ceps and  the  insertion  of  the  deltoides.  The  use  of 
it  is  to  draw  the  arm  forward.  A small  portion  of 
the  lower  part  of  this  muscle  is  often  confounded 
with  the  obliquus  descendens  abdominis ; and  in 
some  bodies,  neither  the  upper  part,  nor  its  tendon, 
can  be  easily  separated  from  the  deltoides  ; and  in 


86 


OF  THE  MUSCLES. 


others,  even  that  part  of  it  that  arises  from  the 
clavicula  is  a distinct  portion.  Near  the  insertion 
of  this  muscle  the  fibres  cross  those  from  below, 
ending  above  in  the  arm,  and  those  from  above 
below,  that  the  tendon  of  this  muscle  might  not 
lie  inconveniently  low  between  the  arm  and  thorax, 
as  it  would  have  done  had  the  fibres  which  arise 
lowest  from  the  sternum  been  inserted  lowest  in  the 
arm ; but  this  crossing  does  not  make  the  tendon 
at  all  stronger,  as  is  often  said  ; nor  can  I see  how 
it  came  to  be  thought  that  this  tendon  should  want 
more  strength  in  proportion  than  other  tendons. 

Deltoides  arises  exactly  opposite  to  the  inser- 
tion of  the  trapezius,  from  one  third  part  of  the 
clavicula,  from  the  acromion  and  spine  of  the  sca- 
pula, and  is  inserted  tendinous  near  the  middle  of 
the  os  humeri,  which  bone  it  lifts  directly  upward. 
The  outermost  parts  of  this  muscle,  when  the  arm 
hangs  down,  lie  below  the  centre  of  motion  of  the 
joint,  and  therefore  can  have  no  share  in  lifting  the 
humerus  up,  till  it  is  raised  part  of  the  way  by  the 
other  part  of  this  muscle,  and  the  following  muscle  ; 
and  as  the  outer  parts  of  this  muscle  begin  to  act, 
the  following  muscle  acts  with  less  advantage  : 
and  it  seems  to  me,  that  the  sole  reason  why  this 
muscle  is  made  of  so  many  parts,  is,  that  they 
may  act  independently  ; for  it  is  demonstrable,  that 
this  muscle,  when  the  whole  of  it  acts,  cannot  raise 
the  arm  with  so  great  advantage  as  a right  lined 
muscle  of  the  same  magnitude  would  have  done. 


OF  THE  MUSCLES. 


87 


Supraspinatus  arises  from  the  dorsum  scapulas 
above  the  spine,  and  passing  between  the  two  pro- 
cesses, is  inserted  into  the  upper  part  of  the  os  hu- 
meri, which  it  helps  to  raise  until  it  becomes  par- 
allel with  the  spina  scapulas. 

The  supraspinatus,  the  deltoides,  and  coracobra- 
chialis  assist  in  all  the  motions  of  the  humerus  ex- 
cept depression ; it  being  necessary  that  the  arm 
should  be  raised  and  sustained,  in  order  to  move  it 
to  any  side. 

Infraspinatus  arises  from  the  dorsum  scapulas 
below  the  spine,  and  is  inserted,  wrapping  over 
part  of  it,  at  the  side  of  the  head  of  the  os  humeri  ; 
it  turns  the  arm  supine  and  backward ; for  there  is 
a prone  and  supine  rotatory  motion  of  the  hume- 
rus of  near  ninety  degrees. 

Teres  minor  is  a small  muscle  arising  below 
the  former  from  the  inferior  costa  scapulae,  and  is 
inserted  together  with  it.  It  assists  the  former  in 
turning  the  arm  supine,  but  pulls  it  more  down- 
wards. 

Teres  major  arises  from  the  lower  angle  of  the 
scapula,  and  is  inserted  at  the  under  part  of  the  os 
humeri,  about  three  fingers  breadth  from  the  head. 
This  draws  the  os  humeri  toward  the  lower  angle 
of  the  scapula,  and  turns  the  arm  prone  and  back- 
ward. 

Latissimus  dorsi  arises  by  a flat  tendon  from 
the  spinal  processes  of  the  seven  or  eight  inferior 
vertebrae  of  the  back,  and  those  of  the  loins,  sa- 


88 


OF  THE  MUSCLES. 


crum,  and  ilium  : and  growing  fleshy,  after  it  has 
passed  the  extensors  of  the  trunk,  receives  another 
small  fleshy  beginning  from  the  ninth,  tenth,  and 
eleventh  ribs,  and  is  inserted  into  the  os  humeri, 
with  the  former.  This  turns  the  arm  backward, 
and  prone.  The  tendon  of  this  muscle  serves  for 
a membrane  to  the  extensors  of  the  back,  and  is 
connected  to  the  transverse  processes  of  the  ver- 
tebrae lumborum. 

Subscapularis  arises  from  the  hollow  side  of 
the  scapula,  which  it  fills  up,  and  is  inserted  in- 
to the  head  of  the  os  humeri,  wrapping  some- 
what over  it.  This  pulls  the  arm  to  the  side  and. 
prone. 

Coracobrachialis  arises  from  the  processus  cora- 
coides  scapulae,  in  common  with  the  origin  of  one 
head  of  the  biceps,  and  is  inserted  into  the  os  hu- 
meri internally  about  its  middle.  This  raises  the 
arm,  and  turns  it  somewhat  outward. 

Biceps  cubiti  flexor  arises  with  two  heads, 
that  the  fibres  of  this  muscle  might  not  compress 
one  another,  one  from  the  processus  coracoides  sca- 
pulae, in  common  with  the  coracobrachialis  mus- 
cle, and  the  other  by  a round  tendon  from  the  edge 
of  the  acetabulum  scapulae,  which  passing  in  a sul- 
cus of  the  os  humeri,  afterward  becomes  fleshy, 
and  joins  the  first  head  to  be  inserted  with  it  into 
the  tubercle  of  the  radius  ; and  sometimes  this 
muscle  has  a third  head,  which  arises  from  the 
middle  of  the  os  humeri.  This  muscle  lifts  up  the 


OF  THE  MUSCLfcSo 


89 


humerus,  bends  the  cubit,  and  has  as  great  a share 
as  any  one  muscle  in  turning  the  cubit  supine  ; the 
humerus  being  fixed  by  other  muscles,  the  whole 
force  of  this  muscle  will  be  exerted  upon  the  cu- 
bit ; or  the  cubit  being  fixed  by  an  extensor,  the 
whole  force  of  it  will  be  spent  in  raising  the  arm, 
and  therefore  ought  to  be  ahvays  reckoned  among 
those  that  raise  a weight  at  arms  length.  A punc- 
ture of  the  tendinous  expansion  of  this  muscle  is 
supposed  to  be  always  attended  with  grievous  pain 
and  inflammation,  and  has,  if  we  have  not  mis- 
taken the  cause,  often  proved  mortal  ; yet  many 
eminent  surgeons  have  given  instances  of  larger 
tendons  being  cut  and  stitched,  without  any  bad 
symptoms  ; and  we  have  often  seen  them  cut, 
torn,  ulcerated,  and  mortified,  without  any  more 
sign  of  pain  than  in  other  parts.  So  that  I can- 
not see  what  the  great  mischief  of  pricking  this 
tendinous  fascia  is  owing  to,  unless  its  lying  so 
much  upon  the  stretch,  which  may  be  wholly 
avoided  by  bending  the  elbow,  and  turning  the 
cubit  prone.  Since  I have  considered  this  case, 

I have  met  with  one  who  was  thus  injured  by 
an  injudicious  blood-letter,  who  ordered  the  pa- 
tient to  keep  her  arm  extended  for  fear  of  a con- 
traction, and  she  was  not  without  the  most  violent 
pain  for  a wdiole  fortnight ; but  upon  bending  the 
cubit,  and  turning  the  arm  prone,  she  grew  pres- 
ently easy,  and,  in  a few  days,  well.  Neverthe- 
less, I am  persuaded,  that  most  of  the  accidents 


N 


90 


®F  Tf H£  MUSCLES. 


which  are  thought  to  be  merely  from  blood-let- 
ting, are  critical  discharges  of  some  disease,  and 
from  the  puncture  a small  inflammation  begin* 
ning,  increases  and  suppurates.  But  however  sin- 
gular I may  be  thought  in  this  opinion,  I can  be 
sure  I am  disinterested  in  it,  having  never  had  any 
ill  accident  follow  blood-letting  in  my  life. 

Brachiaeus  inter nus  arises  from  below  the  mid- 
dle of  the  os  humeri,  and  is  inserted  into  a rough 
place  of  the  ulna,  immediately  below  the  the  junc- 
ture. This  also  bends  the  cubit. 

Supinator  radii  longus  arises  from  the  tlower 
and  outer  part  of  the  os  humeri,  and  is  insert- 
ed into  the  upper  side  of  the  radius,  near-  the 
carpus.  This  muscle  is  not  a supinator  but  a 
bender  of  the  cubit,  and  that  with  a longer  lev- 
er than  either  of  the  two  former  muscles,  and 
is  less  concerned  in  turning  the  cubit  supine, 
than  either  the  extensors  of  the  carpus,  fingers,  or 
thumb. 

Triceps  extensor  cubiti,  commonly  distinguish- 
ed into  biceps  and  brachiseus  externus.  The  first 
of  these  heads  arises  from  the  lower  costa  of  the 
scapula  near  the  acetabulum  ; the  second  from  the 
outer  and  back  part  of  the  os  humeri ; the  third, 
lower  and  more  internal  ; and  are  inserted  into 
the  processus  olecranon  of  the  ulna.  The  first  of 
these  heads  draws  the  arm  backward,  with  as  long  a 
lever  as  it  extends  the  cubit. 


eF  THE  MUSCLES.  91 

Anconseus  arises  from  the  outward  extuberance 
of  the  os  humeri,  and  is  inserted  into  the  upper 
part  of  the  ulna  : this  is  also  an  extensor. 

Palmaris  longus  arises  small  from  the  inner  extu- 
berance of  the  os  humeri,  and  from  a short  belly- 
soon  becomes  a tendon,  which  is  connected  to  the 
ligamentum  transversale  carpi,  and  expanded  in  the 
palm  of  the  hand.  This  muscle  is  often  wanting, 
but  the  expansion  in  the  hand  never  ; yet  it  being 
connected  to  the  ligament  of  the  carpus,  it  must 
bend  the  carpus,  and  cannot  constrict  the  palm  of 
the  hand  ; and  when  it  is  wanting,  the  flexor  car- 
pi radialis  is  larger. 

Palmaris  breyis,  or  caro  quadrata,  arises  obscure- 
ly from  the  ligamentum  transversale  carpi,  and 
seems  to  be  inserted  into  the  eighth  bone  of  the  car- 
pus, and  the  metacarpal  bone  of  the  little  finger. 
This  helps  to  constrict  the  palm  of  the  hand,  and  is 
very  different  in  size  in  different  bodies. 

Flexor  carpi  radialis  arises  from  the  inner  extube- 
rance  of  the  os  humeri,  and  soon  becoming  a strong 
tendon,  passes  through  a channel  of  the  fifth  bone 
of  the  carpus,  and  is  inserted  into  the  metacarpal 
bone  of  the  fore-finger.  This  not  only  bends  the 
carpus  upon  the  radius,  but  also  the  bones  of  the 
second  order  upon  those  of  the  first ; which  mo- 
tion is  nearly  as  much  as  that  upon  the  radius. 

Flexor  carpi  ulnaris  arises  from  the  same  extu- 
berance with  the  former,  and  a fascia  betwixt  this 
muscle  and  the  tensor  ulnaris  contiguous  to  the 


92 


07  THE  MUSCLES. 


ulna,  and  is  inserted  by  a short  tendon  into  the 
fourth  bone  of  the  carpus. 

Extensores  carpi  radiales  ; the  first  arises  from 
the  os  humeri,  immediately  below  the  supinator 
radii  longus,  and  is  inserted  into  the  metacarpal 
bone  of  the  first  finger  ; the  second  arises  immedi- 
ately below  this,  from  the  outer  extuberance  of  the 
os  humeri,  and  is  inserted  into  the  metacarpal  bone 
of  the  second  finger.  The  first  of  these  muscles  is 
a bender  of  the  cubit,  as  well  as  an  extensor  of  the 
carpus,  and  its  often  acting  with  the  benders  of  the 
cubit  while  the  other  is  not  in  action,  is  the  reason 
why  it  is  so  distinct  from  it. 

Extensor  ulnaris  arises  from  the  same  extube- 
rance with  the  former,  and  half  the  ulna  below  the 
anconeus  muscle  ; then  becoming  a tendon,  runs 
in  a small  sinus  at  the  bottom  of  the  ulna,  and  is 
inserted  into  the  metacarpal  bone  of  the  little  fin- 
ger. See  Ulna,  p.  31,  32.  The  extensors  of  the 
carpus  being  inserted  into  the  metacarpus,  at  once 
perform  the  motion  between  the  bones  of  the  car- 
pus, and  that  between  the  carpus  and  radius.  The 
flexor  and  tensor  ulnaris  acting  together  turn  the 
hand  downward,  the  tensor  and  flexor  radialis  up- 
ward. 

Perforatus,  or  flexor  secundi  internodii  dig- 
itorum,  arises  from  the  inner  tubercle  of  the 
os  humeri,  and  from  the  upper  part  of  the 
ulna,  and  the  middle  of  the  radius ; then  becom- 
ing four  strong  tendons,  passes  under  the  ligamen- 


OF  THE  MUSCLES. 


93 


turn  transversale  carpi,  and  is  inserted  into  the  be- 
ginning  of  the  second  bone  of  each  finger. 

Perforans,  or  flexor  tertii  internodii  digitorum, 
arises  from  half  the  ulna,  and  a great  part  of  the 
ligament  between  the  ulna  and  radius,  then  be- 
coming four  tendons,  passes  under  the  ligamen- 
tum  transversale  carpi,  and  through  tendons  of  the 
former  muscle  to  their  insertion  into  the  third 
bone  of  each  finger.  The  tendons  of  both  these 
muscles  are  tied  down  to  the  fingers  by  a strong 
ligament.  If  these  muscles  had  not  passed  one 
through  the  other,  the  perforatus,  which  is  the 
lesser  muscle,  must  have  gone  to  the  last  joint 
where  the  stronger  muscle  is  wanted  ; and,  besides, 
the  tendons  of  the  second  joints  would  have  pressed 
those  that  bend  the  last,  and  not  lain  firmly  upon 
them  neither. 

Lumbricales,  or  flexores  primi  internodii  digit- 
orum,  arise  from  the  tendons  of  the  last  mention- 
ed muscle,  and  are  inserted  laterally  toward  the 
thumb  into  the  beginning  of  the  first  bone  of  each 
finger. 

Extensor  digitorum  communis  arises  from  the 
outer  extuberance  of  the  os  humeri,  and  passing 
under  a ligament  at  the  wrist,  is  divided  into  four 
tendons,  which  communicate  upon  the  first  joint, 
which  keeps  them  from  sliding  off  the  joints  of 
the  fingers,  where  they  are  a little  connected  to  the 
first  bones,  and  afterward  are  inserted  into  the  be- 
ginning of  the  second  bone  of  each  finger. 


94 


OF  TH£  MUSCLES. 


Extensor  auricularis,  or  minimi  digiti  is  a por- 
tion of  the  last  muscle  passing  under  the  ligament  in 
a distinct  channel. 

Extensor  indicis  arises  from  the  middle  of  the 
ulna,  and  passing  under  the  ligament  of  the  car- 
pus, is  inserted  with  the  extensor  communis  into 
the  fore-finger.  This  muscle  extends  the  fore-fin- 
ger singly.  I have  twice  seen  it  wanting. 

Abductor  primi  digiti,  interossei,  and  abductor 
minimi  digiti,  are  eight  muscles,  one  for  each 
side  of  each  finger.  Abductor  primi  digiti 
arises  from  the  first  bone  of  the  thumb,  and  the 
side  of  the  metacarpal  bone  of  the  first  finger. 
The  interossei  are  three  pair,  fitly  divided  into 
external  and  internal  ; the  external  arise  from 
the  metacarpal  bones,  whose  spaces  they  fill  up 
next  the  back  of  the  hand ; the  internal  arise 
from  the  same  bones,  in  the  inside  of  the  hand. 
Abductor  minimi  digiti  arises  from  the  trans- 
verse ligament,  and  fourth  bone  of  the  carpus ; 
these  muscles  are  inserted,  two  into  the  first  joint 
of  each  finger,  and  then  passing  obliquely  over 
the  tops  of  the  fingers,  are  inserted  into  their  last 
bones  *,  they  bend  the  first  joints,  and  extend  the 
two  last,  as  in  holding  a pen,  and  in  playing  upon 
some  musical  instruments.  The  abductors  of  the 
fore  and  little  fingers,  with  the  second  and  fifth 
interossei  muscles  acting,  the  fingers  are  divari- 
cated,  and  the  other  four  acting  bring  them  to- 
gether, and  these  muscles  which  divaricate  the 


OF  THE  MUSCLES. 


95 


fingers,  being  extenders  of  the  second  and  third 
joints,  we  never  can  divaricate  them  without  ex- 
tending them  a little. 

Adductorossis  metacarpiminimi  digiti  arises  from 
the  eighth  bone  and  transverse  ligament  of  the  car- 
pus, and  is  inserted  into  the  metacarpal  bone  of  the 
little  finger,  which  it  pulls  toward  the  thumb  to 
constrict  the  palm  of  the  hand. 

Extensor  primi  internodii  pollicis  arises  from 
the  ulna  below  the  anconeus  muscle,  and  the  lig- 
ament between  the  ulna  and  radius  ; then  becom- 
ing two,  three,  or  four  tendons,  is  inserted  into 
the  fifth  bone  of  the  carpus,  and  first  of  the 
thumb.  The  first  of  these  insertions  can  only  as- 
sist the  bending  of  the  wrist  upward,  and  in  turn- 
ing the  arm  supine. 

Extensor  secundi  internodii  pollicis  arises  im- 
mediately below  the  former  from  the  radius  and 
transverse  ligament,  and  is  inserted  by  a few  fi- 
bres into  the  second  bone  of  the  thumb,  but  chief- 
ly into  the  third. 

Extensor  tertii  internodii  pollicis  arises  imme- 
diately below  the  last  described,  from  the  ulna 
and  ligament,  and  passes  over  the  radius  near- 
er the  ulna,  to  be  inserted  at  the  third  bone  of  the 
thumb.  This  extends  the  thumb  more  toward 
the  ulna  than  the  former  muscle,  and  is  very  much 
a supinator. 

Flexor  primi  et  secundi  ossis  pollicis  arises 
from  the  fifth  bone  and  transverse  ligament 


96 


OF  THE  MUSCLES. 


of  the  carpus,  and  from  the  beginnings  of  the  two 
first  metacarpal  bones,  and  is  inserted  into  the 
whole  length  of  the  first  bone  of  the  thumb,  and 
tendinous  into  the  beginning  of  the  second  ; the 
sesamoid  bones  of  the  thumb  in  such  bodies  as 
have  them,  he  in  this  tendon,  where  it  passes  over 
the  joint. 

Flexor  tertii  internodii  pollicis  arises  large 
from  almost  all  the  * upper  part  of  the  radius, 
and  becoming  a round  tendon,  passes  under  the 
ligamcntum  transversale  carpi,  to  be  inserted  into 
the  third  bone  of  the  thumb.  This  muscle  singly 
acting,  draws  the  thumb  towards  the  metacarpal 
bone  of  the  little  finger ; but  the  last  mentioned 
muscle  acting  with  it,  turns  it  toward  the  fore- 
finger. 

Adductor  pollicis  arises  from  the  carpus,  and 
almost  the  whole  length  of  the  metacarpal  bone 
of  the  long  finger,  and  is  inserted  into  the  begin- 
ning of  the  second  bone  of  the  thumb.  This  mus-i 
cle  naturally  enough  divides  into  two,  and  might 
better  be  called  a flexor  than  adductor. 

Abductor  pollicis  arises  from  the  fifth  bone 
and  ligamentum  transversale  of  the  carpus,  and 
is  inserted  laterally  into  the  beginning  of  the 
second  bone  of  the  thumb,  to  draw  it  toward  the 
radius. 

The  muscles  which  bend  the  thumb  are  much, 
less  than  those  which  bend  the  fingers  ; neverthe- 
less, the  thumb  is  able  to  resist  all  the  fingers. 


OF  THE  MUSCLES. 


57 


merely  from  the  advantages  that  arise  from  the 
thickness  and  shortness  of  the  bones  of  the  thumb, 
compared  with  those  of  the  fingers  ; but  then  the 
quickness  of  motion  in  the  fingers  will  exceed  that 
of  the  thumb,  as  much  as  the  fingers  exceed  the 
thumb  in  length,  and  their  muscles  those  of  the 
thumb  in  largeness. 

Supinator  radii  brevis  arises  from  the  outer 
extuberance  of  the  os  humeri,  and  upper  part  of 
the  ulna,  and  running  half  round  the  radius,  is  in- 
serted near  its  turbercle. 

Pronator  teres  arises  from  the  inner  apo- 
physis of  the  os  humeri,  and  upper  and  fore  part  of 
the  ulna,  and  is  inserted  tendinous  into  the  radius 
below  the  former.  t * 

Pronator  quadratus  arises  from  the  lower  edge 
of  the  ulna,  near  the  carpus,  and  passing  under  the 
flexors  of  the  fingers  is  inserted  into  the  radius. 

These  muscles  are  occasionally  assisted  in  their 
actions  by  the  muscles  of  the  hands,  the  extensors 
assisting  the  supinators,  and  the  flexors  the  prona- 
tors, and  most  of  the  extensors  of  the  hand  take  a 
great  part  of  their  origin  from  the  tendinous  fascia 
that  covers  them. 

Mastoideus  arises  tendinous  from  the  sternum 
near  the  clavicula,  and  by  a separate  fleshy  por- 
tion from  the  clavicula,  which  soon  unites  with 
the  other  beginning,  and  is  inserted  into  the  outer 
part  of  the  mammillary  process  of  the  temporal 
bone.  It  pulls  that  side  of  the  head  it  is  inserted 


o 


98 


OF  THE  MUSCLES. 


into  towards  the  sternum,  and  turns  the  face  to- 
ward the  contrary  shoulder.  This,  and  its  fellow, 
pull  the  head  and  neck  toward  the  breast,  and  act 
with  a much  longer  lever  upon  each  lower  verte- 
bra, than  they  do  upon  the  next  above,  and  with 
more  power  upon  any  of  those  joints  than  upon 
the  head.  This  muscle  being  inserted  into  the 
head,  beyond  the  centre  of  motion  of  the  head 
with  the  first  vertebra,  has  been  supposed,  by  sever- 
al anatomists,  to  pull  the  head  backward  ; but  the 
passing  beyond  signifies  nothing  to  that  purpose, 
unless  a line  going  through  its  axis  would  pass  be- 
low the  centre  of  motion  : and  it  is  the  more  to  be 
wondered  how  this  mistake  prevailed,  if  we  consider 
that  this  muscle’s  being  added  to  the  extensors  of 
the  head  and  neck,  would  make  the  force  of  that 
action  a hundred  times  greater  than  that  of  the 
benders.  And  if  this  is  not  enough  to  convince, 
let  any  one  lying  on  his  back  raise  his  head,  and 
he  will  soon  feel  this  muscle  in  action  ; but  bow- 
ing the  head  forward  in  an  erect  posture  will  not 
shew  this  unless  some  resistance  is  made  to  the 
head,  because  the  centre  of  gravity  of  the  head  ly- 
ing before  the  centre  of  motion,  there  needs  no 
more  than  a relaxation  of  the  extensors,  to  bring 
the  head  forward  in  that  posture. 

Rectus  internus  major  arises  from  the  anterior 
part  of  the  transverse  processes  of  the  third,  fourth, 
fifth,  and  sixth  cervical  vertebrae ; and  passing 
over  the  two  superior,  is  inserted  into  a rough- 


OF  THE  MUSCLES. 


99 


ness  of  the  occipital  bone  near  the  fore-part  of  the 
great  foramen.  This  bends  the  head  on  the  two 
first  vertebrae  of  the  neck. 

Rectus  minor  internus  arises  under  the  last 
muscle,  from  the  first  vertebra,  and  is  inserted 
under  it  into  the  os  occipitis.  This  bends  the  head 
on  the  first  vertebra. 

Rectus  lateralis  arises  from  the  anterior  part  of 
the  transverse  process  of  the  first  vertebra  of  the 
neck,  and  is  inserted  into  the  os  temporis  and 
occipitis  between  the  mammillary  and  styloid  pro- 
cesses. This  turns  the  head  on  one  side. 

Splenius  arises  by  a thin  tendon  from  the  spi- 
nal processes  of  the  five  superior  vertebrae  of  the 
thorax,  and  the  lowest  of  the  neck,  and  linea  alba 
colli,  and  is  inserted  into  the  os  occipitis,  the  up- 
per part  of  the  mammillary  process  of  the  temporal 
bone,  and  the  transverse  processes  of  the  three 
superior  cervical  vertebrae.  This  pulls  the  head 
and  neck  backward,  and  to  the  contrary  side  ; but 
both  of  these  acting  together  pull  them  directly 
backward. 

Complexus  arises  from  the  transverse  processes 
of  the  six  or  seven  superior  vertebrae  of  the  thorax  ; 
and  six  inferior  of  the  neck,  and  is  inserted  into 
the  os  occipitis,  and  back  part  of  the  os  temporis  ; 
this  last  part  is  sometimes  distinct  enough  to  be 
accounted  another  muscle.  It  pulls  the  head  and 
neck  back. 


100 


or  THE  MUSCLES. 


Rectus  major  posticus  arises  from  the  spinal 
processes  of  the  second  vertebra  of  the  neck,  and 
is  inserted  broader  into  the  os  occipitis.  It  pulls 
the  head  back  on  the  two  first  vertebne. 

Rectus  minor  posticus  arises  from  the  back 
part  of  the  first  vertebra  of  the  neck,  it  having  no 
spinal  process,  and  is  inserted  below  the  former  into 
the  same  bone,  to  pull  the  head  back  on  the  first 
vertebra. 

Obliquus  superior  arises  from  the  transverse  pro- 
cess of  the  first  vertebra,  and  is  inserted  into  the  os 
occipitis  and  back  part  of  the  os  temporis,  near 
the  rectus  major  ; either  of  these  acting,  assist  the 
rectus  lateralis  on  the  same  side ; but  both  together 
pull  the  head  back. 

Obliquus  inferior  arises  from  the  spinal  process 
of  the  second  vertebra  of  the  neck,  and  is  inserted 
into  the  transverse  process  of  the  first.  This,  with 
its  fellow,  alternately  acting,  turns  the  head  with 
the  first  vertebra  in  a rotatory  manner  on  the 
second,  whose  processus  dentatus  is  the  axis  of  this 
motion. 

Interspinales  colli  are  three  or  four  pair  of  mus- 
cles between  the  bifid  processes  of  the  cervical  ver- 
tebrae, which  they  draw  nearer  each  other  when  the 
neck  is  bent  backward. 

Longus  colli  arises  laterally  from  the  bodies 
of  the  four  superior  vertebrae  of  the  thorax,  and 
from  the  anterior  part  of  the  transverse  processes  of 
the  five  inferior  vertebrae  of  the  neck,  and  is  in- 


OF  THE  MUSCLES.  101 

serted  into  the  fore  part  of  the  first  and  second  ver- 
tebrae of  the  neck,  which  it  bends  forward. 

Intertransversales  colli  are  portions  of  flesh  be- 
tween the  transverse  processes  of  the  vertebrae 
of  the  neck,  like  the  interspinales,  but  not  so  dis- 
tinct ; they  draw  these  processes  together. 

Spinalis  colli  arises  from  the  transverse  proces- 
ses of  the  five  superior  vertebrae  of  the  back,  and 
is  inserted  into  the  spinal  processes  of  the  second, 
third,  fourth,  and  fifth  vertebrae  of  the  neck.  This 
pulls  the  neck  backward. 

Transversalis  colli  arises  from  the  oblique 
processes  of  the  four  inferior  vertebrae  of  the 
neck,  and  is  inserted  into  the  spinal  process  of  the 
second  vertebra  of  the  neck.  This  muscle  is  but 
a continuation  of  the  transversalis  or  semispinalis 
dorsi. 

The  muscles  of  the  head  and  neck  are  most  of 
them  obliquely  directed,  which  makes  them  per- 
form the  oblique  motions,  as  well  as  extension  and 
flexion  ; which  is  highly  convenient  in  this  case, 
because  the  joints  moved  by  these  muscles,  being 
under  the  weight  moved,  it  is  necessary  that  the 
head  should  be  kept  steady  by  the  extensors,  and 
flexors  too,  when  any  great  weight  is  upon  the 
head ; and  these  muscles,  from  the  obliquity  of 
their  directions,  not  only  perform  these  two  actions 
at  once,  but  acting  by  pairs  they  move  the  head 
and  neck  steadily,  in  a diagonal  direction,  which 
■straight  muscles  could  not  have  done  so  well. 


102 


OF  THE  MUSCLES. 


Scalenus  arises  from  the  transverse  processes 
of  the  second,  third,  fourth,  fifth  and  sixth  cervi- 
cal vertebrae.  It  is  inserted,  in  three  parts,  into 
the  two  uppermost  ribs,  being  thus  divided  for  the 
transmission  of  the  subclavian  vessels.  This  mus- 
cle may  bend  the  neck  ; but  its  chief  use  is  to  sup- 
port the  upper  ribs,  which  is  necessary  to  deter- 
mine the  contraction  of  the  intercostal  muscles 
that  way,  and  a ligament  could  not  have  done 
this,  because  of  the  various  positions  that  the  neck 
and  back  are  liable  to. 

Serratus  superior  posticus  arises  with  a thin  ten- 
don, inseparable  from  the  rhomboides,  from  the 
spinal  process  of  the  inferior  cervical  vertebra,  and 
the  three  superior  of  the  thorax,  and  is  inserted  in- 
to the  second,  third,  and  fourth  ribs,  immediately 
beyond  their  bendings ; this,  with  the  scalenus,  sus- 
tains the  upper  ribs,  that  they  might  not  be  pull- 
ed downward  by  the  depressors  of  the  ribs  in  ex- 
spiration,  as  the  lower  ribs  are  upward  in  inspi- 
ratiom 

Serratus  inferior  posticus  arises  with  a broad 
tendon,  inseparable  from  that  of  the  latissimus 
dorsi,  from  the  spinal  processes  of  the  three  supe- 
rior vertebrae  of  the  loins,  and  two  inferior  of  the 
thorax,  and  is  inserted  into  the  tenth  rib,  but  chief- 
ly the  ninth  and  eleventh  : it  pulls  down  the  ribs  in 
exspiration. 

Intercostales  are  eleven  pair  on  each  side,  in 
the  interstices  of  the  ribs  ; from  their  situations 


OF  THE  MUSCLES. 


103 


distinguished  into  the  external  and  internal ; they 
all  arise  from  the  under  edge  of  each  rib,  and  are 
inserted  into  the  upper  edge  of  the  rib  below. 
The  external  are  largest  backward,  having  their 
first  beginnings  from  the  transverse  processes  of  the 
vertebrae,  like  distinct  muscles,  which  some  call  le- 
vatores  costarum.  The  internal  run  all  from  above 
obliquely  backward ; being  thickest  forward,  and 
thinnest  toward  the  spine.  These  are  also  continu- 
ed betwixt  the  cartilages  of  the  sternum,  with-fi- 
bres  perpendicular  to  the  cartilages  ; and  between 
the  cartilages  of  the  lowest  ribs,  they  are  insepa- 
rable from  the  obliquus  ascendens  abdominis.  These 
muscles,  by  drawing  the  ribs  nearer  to  each  other, 
pull  them  all  upward,  and  dilate  the  thorax,  they 
being  sustained  at  the  top  by  the  scalenus  and  ser- 
ratus  superior  posticus.  To  these  Mr.  Cowper 
adds  some  fleshy  fibres,  which  run  from  one  rib 
over  a second  to  a third,  near  the  spine,  which  are 
levatores  costarum. 

Triangularis  sterni  arises  internally  from  the 
cartilago  ensiformis,  and  the  lower  edge  of  the  os 
pectoris,  and  is  inserted  into  the  end  of  the  third, 
fourth,  fifth  and  sixth  ribs.  This  pulls  the  ribs  to 
the  bone  of  the  sternum,  and  thereby  bends  its  car- 
tilages in  exspiration. 

Diaphragma  arises,  on  the  right  side,  by  a pro- 
cess from  three  lumbal  vertebrae,  and  one  of  the 
thorax ; and  on  the  left,  from  the  one  superior  of 
the  loins,  and  inferior  of  the  thorax  j this  last  part 


104 


OF  THE  MUSCLES. 


being  less  to  give  way  to  the  great  artery,  and  is- 
inserted  into  the  lower  part  of  the  sternum  and  the 
five  inferior  ribs.  The  middle  of  this  muscle  is  a 
flat  tendon,  from  whence  the  fleshy  fibres  begin 
and  are  distributed,  like  radii,  from  a centre  to  a 
circumference.  When  this  muscle  acts  alone,  it 
constricts  the  thorax,  and  pulls  the  ribs  downward, 
and  approaches  toward  a plane  ; which  action  is 
generally  performed  to  promote  the  ejection  of  the 
faeces.  In  large  inspirations,  when  the  intercostals 
lift  up  the  ribs  to  widen  the  thorax,  this  muscle 
acts  enough  to  bring  itself  toward  a plane,  without 
overcoming  the  force  of  the  intercostals,  by  which 
means  the  breast  is  at  once  widened  and  lengthen- 
ed : when  it  acts  with  the  abdominal  muscles,  it 
draws  the  ribs  nearer  together,  and  constricts  the 
thorax,  and  the  superior  force  of  the  abdominal 
muscles  thrusting  the  parts  of  the  lower  belly  against 
it,  it  becomes  at  the  same  time  convex  upward,  and 
shortens  the  thorax,  which  occasions  the  largest 
exspirations  ; or  acting  alternately  with  the  abdom- 
inal muscles  only,  a more  moderate  inspiration  and 
exspiration  is  made  by  shortening  and  lengthen- 
ing the  thorax  only,  which  is  what  we  chiefly  do 
when  lying  down  ; or  acting  alternately  with  the 
intercostals  only,  a moderate  exspiration  and  inspi- 
ration is  caused,  by  the  widening  and  narrowing  the 
breast,  which  is  what  we  are  most  prone  to  in  an 
erect  position,  the  muscles  of  the  abdomen  at  such 
times  being  employed  in  supporting  the  parts  con- 


OF  THE  MUSCLES. 


105 


tained  in  the  abdomen.  And  though  these  mo- 
tions of  the  ribs  require  at  any  one  time  but  very 
little  force,  the  air  within  the  thorax  balancing  that 
without ; yet  that  these  muscles,  whose  motions  are 
essential  to  life,  may  be  never  weary,  the  inspirators 
in  most  men  have  force  sufficient  to  raise  mercury 
in  a tube  four  or  five  and  twenty  inches  in  an  „ 
erect  posture,  and  the  exspirators  six  or  seven  ; the 
first  of  which  will  require  about  four  thousand 
pound  force  in  most  men,  and  the  other  propor- 
tional. But  I imagine,  that  lying  down,  these  pro- 
portions will  differ  by  the  weight  of  the  parts  con- 
tained in  the  abdomen.  In  all  the  bodies  I have 
dissected,  I have  found  the  diaphragm  convex  up-  9 * 
ward,  which  gave  me  occasion  to  think,  that  all 
animals  died  in  exspiration  ; till  the  forementioned 
experiment  discovered,  that  the  muscles  of  inspira- 
tion were  stronger  than  those  of  exspiration  ; which 
led  me  to  make  the  following  experiment.  I cut 
the  wind-pipe  of  a dog,  and  having  a string  ready 
fixed,  I put  a cork  into  it,  and  tied  it  fast  instantly 
after  inspiration  ; upon  which  I observed,  that  the 
diaphragm,  and  the  other  muscles  of  inspiration  and 
exspiration,  were  alternately  contracted  and  distend- 
ed for  some  time  ; but  when  he  was  dead,  the  ab- 
dominal muscles  were  in  a state  of  contraction,  the 
ribs  were  elevated  to  dilate  the  thorax,  and  the 
diaphragm  was  convex  upward.  This  experiment 
also  shews,  that  the  diaphragm  is  not  a muscle  of 
equal  force  either  to  the  depressors  or  elevators  of 


p 


106 


OF  THE  MUSCLES. 


the  ribs,  it  neither  hindering  the  elevators  from 
raising  the  breast  ; nor  the  depressors  from  thrust- 
ing it  upward,  by  compressing  the  parts  contained 
in  the  abdomen,  though  the  breast  was  full  of 
air. 

Sacer  sacrolumbalis,  longissimus  dorsi,  and  semi- 
spinalis,  are  all  that  portion  of  flesh  betwixt  the  os 
sacrum  and  the  neck,  which  seeing  there  is  no 
membrane  to  distinguish  it  into  several  muscles,  and 
that  it  is  all  employed  in  the  same  actions,  I shall 
give  it  the  name  of  extensor  dorsi  et  lumborum, 
and  describe  it  all  as  one  muscle. 

Extensor  dorsi  et  lumborum  arises  from  the 
upper  part  of  the  os  sacrum,  the  spine  of  the  os 
ilium,  the  back  parts  of  the  lowermost  vertebrae 
of  the  loins,  and  remarkably  from  those  strong  ten- 
dons which  appear  on  their  outsides.  That  part  of 
this  muscle,  which  is  known  by  the  name  of  sacro- 
lumbalis, is  inserted  into  all  the  ribs  near  their  ar- 
ticulations, with  the  transverse  processes  of  the  ver- 
tebrae, and  into  the  transverse  process  of  the  last 
vertebra  of  the  neck  ; besides,  as  this  passes  over 
the  ribs,  it  receives  an  origin  from  every  rib,  in  a 
manner  that  cannot  well  be  described.  The  por- 
tions of  this  muscle,  which  arise  from  the  ribs,  and 
are  inserted  into  the  other  ribs  above,  will  necessa- 
rily draw  the  back  part  of  the  ribs  nearer  together, 
which  must  always  be  done  as  the  back  extends, 
and  independent  of  other  actions  of  the  thorax. 
The  next  portion  of  this  muscle,  called  longissimus 


0E  THE  MUSCLES. 


1-07 


dorsi,  is  inserted  into  all  the  transverse  processes  of 
the  vertebrae  of  the  back,  and  partly  into  the  ribs, 
and  the  uppermost  transverse  processes  of  the  verte- 
brae of  the  loins  ; and  the  upper  end  of  it  is  neither 
very  distinct  from  the  complexus  of  the  head,  nor 
spinalis  of  the  neck.  The  rest  of  this  muscle, 
known  by  the  names  of  semispinalis,  sacer,  &c. 
arises  also  from  all  the  transverse  and  oblique  pro- 
cesses of  the  loins  and  back  ; every  portion,  except 
the  lowermost,  passing  over  live  joints,  is  inserted 
into  the  spinal  process  of  the  sixth  vertebra  above 
its  origin,  all  the  way  up  the  back,  and  at  the 
neck  commences  transversalis  colli.  This  passing 
of  each  portion  of  a muscle  over  a few  joints,  dis- 
tributes their  force  equally  enough  among  all  these 
joints,  without  the  fibres  being  directed  more  ob- 
liquely than  those  of  penniform  muscles ; but  the 
neck  and  loins  not  having  sufficient  provision  of 
this  sort,  there  are  small  muscles  between  their  pro- 
cesses, which,  though  they  are  of  little  importance 
for  the  motions  of  those  parts,  yet  are  sufficient  to 
distribute  the  force  of  larger  muscles  equally 
among  those  joints ; and,  besides  the  uses  of  the 
extensor  dorsi  et  lumborum,  which  its  name  im- 
plies, it  and  its  fellow  alternately  raise  the  hips  in 
walking,  which  any  one  may  feel  by  laying  his 
hand  upon  his  back. 

Quadratus  lumborum  arises  from  the  upper 
part  of  the  spine  of  the  ilium,  and  is  inserted  in- 
to all  the  transverse  processes  of  the  four  upper- 


108 


OF  THE  MUSCLES. 


most  lumbal  vertebrae.  This,  and  its  fellow,  act- 
ing alternately,  assist  the  last  mentioned  muscle  in 
raising  the  ossa  innominata  in  progression  : or  each 
acting  singly,  while  the  lower  limbs  are  not  moved, 
inclines  the  body  to  one  side. 

Intertransversales  lumborum,  are  small  mus- 
cles seated  between  all  the  transverse  processes  of 
the  vertebrae  lumborum,  to  bring  them  nearer  to- 

Psoas  parvus  arises  laterally  from  the  body  of 
the  first  lumbal  vertebra,  and  the  lowest  of  the 
back,  and  soon  becoming  a small  tendon,  is  inserted 
into  the  os  pubis,  near  the  ilium.  It  either  assists 
in  bending  the  loins  forward,  or  raising  the  os  in- 
nominatum  in  progressive  motions.  This  muscle 
is  often  wanting. 

Psoas  magnus  arises  laterally  from  the  bodies 
and  transverse  processes  of  the  four  superior  ver- 
tebrae of  the  loins,  and  the  last  of  the  back,  and  is 
inserted  with  the  following  muscle  into  the  lesser 
trochanter.  This  bends  the  thigh,  and  when  the 
psoas  parvus  is  wanting,  this  is  larger. 

Iliacus  internus  arises  from  the  concave  part 
of  the  ilium,  and  from  its  lower  edge,  and  passing 
over  the  ilium,  near  the  os  pubis,  joins  the  former 
muscle,  and  is  inserted  with  it,  to  be  employed  in 
the  same  action. 

Pectineus  arises  from  the  os  pubis  or  pectinis, 
near  the  joining  of  that  bone  with  its  fellow,  and 
is  inserted  into  the  linea  aspera  of  the  thigh  bone. 


OF  THE  MUSCLES. 


109 


four  fingers  breadth  below  the  lesser  trochanter. 
This  bends  the  thigh,  and  turns  the  toes  outward. 

Triceps  femoris.  The  two  lesser  heads  of  this 
muscle  arise  under  the  pectineus,  and  the  third 
from  the  inferior  edges  and  back  part  of  the  os 
pubis  and  ischium,  and  is  inserted  into  the  whole 
length  of  the  linea  aspera  and  the  inner  apophysis 
of  the  os  femoris.  This  also  bends  the  thigh,  and 
turns  the  toes  outward.  When  the  thigh  bone  is 
moved  in  a plane,  which  cuts  at  right  angles  a plane 
that  passes  through  the  axis  of  either  head  of  the 
last  muscle,  that  head  rising  lower  than  the  centre 
of  motion  of  the  hip  joint,  it  will  either  assist  the 
flexors  or  extensors,  and  that  most  when  the 
bone  has  been  moved  most  backward  or  forward  : 
and  as  either  of  these  heads  lie  more  or  less  out 
of  the  said  plane,  they  will  give  greater  assistance 
to  that  motion  which  is  made  on  the  side  of  the 
said  plane,  contrary  to  their  situation,  and  less  on 
the  same  side.  This  mechanism  is  frequently 
made  use  of  to  make  one  muscle  serve  different 
actions ; but  I have  only  explained  it  in  this  in- 
stance, because  it  is  the  most  considerable  one  that 
I know. 

Cluteus  maximus  arises  from  the  back  part  of 
the  spine  of  the  ilium,  and  the  dorsum  ilii,  and 
side  of  the  os  coccygis  and  sacrum,  and  a ligament 
extended  between  these  bones,  and  from  a thin 
fascia,  spread  over  that  part  of  the  following 
muscle  which  this  does  not  cover,  and  is  inserted 


110 


or  THE  MUSCLES. 


by  a strong  tendon  into  the  upper  part  of  the  linea 
aspera  of  the  thigh  bone,  and  also  into  the  flat  ten- 
don of  the  fascialis  muscle,  which  insertion  into,  or 
connexion  with,  that  tendon,  raises  this  muscle 
farther  from  the  centre  of  motion,  and  increases  its 
strength.  This  extends  the  thigh,  and  both  these 
together  being  contracted,  occasionally  assist  the 
levatores  ani  in  supporting  the  anus.  The  breadth 
of  the  origin  and  insertion  of  this  muscle  is  very 
observable  ; for  by  that  means,  though  it  is  the 
largest  muscle  in  the  body,  it  is  nevertheless  right- 
lined,  without  one  fibre  compressing  another  any 
more  than  in  penniform  muscles. 

Gluteus  medius  arises  from  all  the  anterior 
part  of  the  spina  and  dorsum  ilii,  and  under  part 
of  the  last  mentioned  muscle,  and  is  inserted  into 
the  upper  part  of  the  great  trochanter  of  the  thigh 
bone.  This  extends  the  thigh  outward. 

Gluteus  minimus  arises  entirely  under  the  for- 
mer, from  the  dorsum  ilii,  and  is  inserted  into 
the  upper  and  anterior  part  of  the  great  trochanter 
and  neck  of  the  thigh  bone  to  extend  the  thigh. 

Pyriformis  arises  internally  from  the  inside  of 
the  os  sacrum,  and  growing,  in  more  than  half  its 
progress,  into  a round  tendon,  is  inserted  into  the 
upper  part  of  the  sinus,  at  the  root  of  the  great  tro- 
chanter. This  assists  somewhat  in  extending  the 
thigh,  but  more  in  turning  it  outward. 

Quadratus  femoris  arises  from  the  obtuse  pro- 
cess of  the  ischium,  and  is  inserted  into  the  up- 


OF  THE  MUSCLES. 


Ill 


per  part  of  the  linea  aspera  of  the  thigh  bone,  be- 
tween the  two  trochanters.  This  draws  the  thigh 
inward,  and  directs  the  toes  outward. 

Obturator  internus  or  marsupialis  arises  gener- 
ally from  a strong  membrane,  or  ligament,  which 
fills  up  the  hole  of  the  os  innominatum,  and 
from  the  circumambient  bone  ; thence  passing 
over  a channel  in  the  ischium,  betwixt  its  two 
processes,  it  receives  from  them  two  other  por- 
tions, which  are  a sort  of  marsupium,  and  is  insert- 
ed into  the  sinus  of  the  great  trochanter.  This 
turns  the  thigh  outward. 

Obturator  externus  arises  opposite  to  the  for- 
mer, from  the  outside  of  the  os  innominatum,  and 
is  inserted  into  the  sinus  of  the  great  trochan- 
ter. This  also  turns  the  thigh  outward.  These 
four  last  mentioned  muscles  acting  with  the  ex- 
tensors, prevent  their  turning  the  toes  inward,  and 
in  stepping  forwards  are  continually  acting  to  turn 
the  toes  outwards  ; for  though  the  toes  are  placed 
perpendicular  to  the  front  of  the  body,  in  taking 
a long  ftep,  these  muscles  bring  them  perpendic- 
ular to  the  side  of  the  body ; and  as  these  direct, 
the  same  extensors  will  turn  the  thigh  either  out- 
ward or  backward,  with  their  full  force. 

Fascialis,  or  membranosus,  arises  from  the  fore- 
part of  the  spine  of  the  ilium,  and  in  about  five 
inches  progress  becomes  a flat  tendon,  or  fascia, 
which  is  joined  by  a considerable  detachment 
from  the  tendon  of  the  gluteus  maximus,  and 


112 


OF  THE  MUSCLES. 


from  the  Iinea  aspera  of  the  thigh  bone,  and 
then  covering  in  an  especial  manner  the  vastus 
externus,  is  inserted  at  the  top  of  the  tibia  and 
fibula,  and  then  proceeds  to  join  the  fascia,  which 
covers  the  upper  part  of  the  muscles  situate  on  the 
outside  of  the  tibia,  and  from  which  a great  part 
of  the  fibres  of  those  muscles  arise.  About  the 
middle  of  the  leg  it  grows  loose,  and  is  so  contin- 
ued to  the  top  of  the  foot,  being  connected  there, 
and  at  the  lower  part  of  the  leg,  to  the  ligaments 
which  tie  down  the  tendons.  This  tendon,  where 
it  covers  the  vastus  externus,  receives  additional 
transverse  fibres,  which  run  through  the  thigh, 
but  are  most  conspicuous  on  the  outside.  This 
draws  the  thigh  outward,  and  passing  over  the 
knee  forwarder  than  its  axis  of  motion,  it  will 
help  to  extend  that  joint. 

Gracilis  arises  from  the  os  pubis,  close  to  the 
penis,  and  is  inserted  into  the  tibia,  four  or  five 
fingers  breadth  below  the  knee.  This  draws  the 
thigh  inward,  and  passing  over  the  knee,  behind 
its  axis  of  motion,  it  will  help  to  bend  it. 

Sartorius  arises  from  the  fore  part  of  the  spine 
of  the  ilium,  and  thence  descending  obliquely 
to  the  inside  of  the  tibia,  is  there  inserted  four  or 
five  fingers  breadth  below  the  joint.  This  at  once 
helps  to  bend  both  the  thigh  and  leg,  particularly 
the  thigh,  at  very  long  levers ; it  directly  helps  to 
lift  up  the  leg  in  walking  up  stairs,  or  laying  the 
legs  across,  like  taylors. 


OF  THE  MUSCLES. 


113 


Semitendinosus  arises  from  the  obtuse  process 
of  the  ischium,  and  growing  a round  tendon  in 
somewhat  more  than  half  its  progress,  is  inserted 
near  the  former  muscles  into  the  tibia  : it  helps  to 
extend  the  thigh  and  bend  the  tibia. 

Semimembranosus  arises  by  a flat  tendon  like 
a membrane  from  the  obtuse  process  of  the  is- 
chium, and  being  continued  tendinous  betwixt  the 
bellies  of  the  last  mentioned  and  following  muscles, 
and  then  growing  fleshy,  becomes  again  tendinous 
above  the  joint,  and  is  inserted  nearer  the  joint 
than  the  former  muscle  for  the  same  use. 

These  two  make  the  internal  hamstring,  and 
arising  and  inserting  so  near  together,  they  might 
have  been  one  muscle,  but  their  fibres  would  have 
been  near  twice  as  long,  which  would  have  given 
a motion  near  twice  as  quick,  but  not  so  strong, 
unless  it  had  been  inserted  at  a distance  from  the 
joint  it  moves  proportionable  to  its  length,  which 
could  not  well  be ; therefore  they  are  made  two 
muscles  of  a number  of  fibres  nearly  equal  to  what 
one  could  have  been,  and  are  inserted  at  distances 
from  the  axis  of  motion  of  the  knee,  proportional 
to  the  different  lengths  of  their  fibres  in  the  direc- 
tions of  their  axis. 

Biceps  tibiae,  the  first  head  arises  in  common 
with  the  two  preceding  muscles,  from  the  obtuse 
process  of  the  ischium ; the  second  from  the  lower 
part  of  the  linea  aspera  of  the  thigh  bone.  This 
soon  joins  the  former,  and  is  inserted  with  it  into 


Q 


114 


OF  THE  MUSCLES. 


the  upper  part  of  the  fibula  to  bend  the  leg,  and 
the  first  head  also  extends  the  thigh.  The  tendon 
of  this  muscle  makes  the  external  hamstring,  when 
the  knee  is  bent ; and  when  we  sit  down,  the  bi- 
ceps will  turn  the  leg  and  toes  outward,  and  the 
semitendinosus  and  semimembranosus  will  turn 
them  inward. 

Popliteus  arises  from  the  outer  apophysis  of  the 
os  femoris,  and  thence  running  obliquely  inward, 
is  inserted  into  the  tibia  immediately  below  its  head. 
This  assists  the  flexors,  and  draws  the  tibia  toward 
the  outer  apophysis  of  the  thigh  bone. 

Rectus  tibiae  arises  with  a tendon  from  the  upper 
part  of  the  acetabulum  of  the  os  innominatum,  and 
by  another  tendon,  which  is  a sort  of  ligament  to 
this,  from  a processus  innominatus  of  the  ilium  be- 
low its  spine  forward,  and  is  inserted,  together  with 
the  three  following  muscles,  into  the  patella.  It 
| bends  the  thigh,  and  extends  the  tibia. 

Vastus  externus  arises  from  the  anterior  part 
of  the  great  trochanter  and  upper  part  of  the  li- 
nea  aspira  of  the  thigh  bone,  and  is  inserted  into 
the  upper  and  external  part  of  the  patella.  It  ex- 
tends the  tibia.. 

Vastus  internus  arises  from  the  inner  and 
lower  part  of  the  linea  aspera,  and  is  inserted  into 
the  upper  and  inner  part  of  the  patella,  to  extend 
the  tibia ; and  the  fibres  of  this  muscle  being  ob- 
lique, it  keeps  the  patella  in  its  place,  the  other 
muscles  lying  in  the  direction  of  the  os  femoris-, 


OF  THE  MUSCLES. 


115 


which  makes  an  obtuse  angle  with  the  tibia,  they 
would  alone  be  liable  to  draw  the  patella  outward. 
This  contrivance  is  most  obvious  in  those  whose 
knees  bend  most  inward. 

Crureus  arises  between  the  two  last,  below  the 
rectus,  from  all  the  convex  part  of  the  os  femoris, 
and  is  inserted  in  like  manner  into  the  patella  ; the 
patella  being  tied  down  by  a strong  ligament  to  the 
tibia.  These  three  last  muscles  extend  the  tibia 
only,  and  might  very  properly  be  called  extensor 
tibiae  triceps. 

Gasterocnemius  arises  by  two  small  beginnings 
above  the  back  part  of  the  apophysis  of  the  os 
femoris,  which  soon  becoming  large  bellies  unite, 
and  then  become  a flat  tendon  which  joins  the  fol- 
lowing muscles  to  be  inserted  into  the  os  calcis. 
The  two  parts  of  this  muscle  are  by  some  writers 
distinguished  into  two  muscles.  Its  use  is  to  extend 
the  tarsus  and  bend  the  knee. 

Plantaris  arises  under  the  outer  beginning  of 
the  last  named  muscle,  from  the  external  apophysis 
of  the  os  femoris,  and  soon  becoming  a small  ten- 
don, is  so  continued  betwixt  the  foregoing  and  sub- 
sequent muscles,  and  is  inserted  with  them.  It 
bends  the  knee,  and  extends  the  tarsus.  Authors 
derive  the  tendinous  expansion  on  the  bottom  of 
the  foot  from  the  tendon  of  this  muscle  ; but  seeing 
the  expansion  is  much  more  than  this  tendon  could 
make,  and  that  this  tendon  can  be  traced  no  far- 
ther than  the  os  calcis,  and  that  the  expansion  is 


116 


OF  THE  MUSCLE&. 


as  large  when  the  muscle  is  wanting,  which  is  not 
seldom,  I cannot  be  of  that  opinion. 

Gasterocnemius  internus  arises  from  the  upper 
part  of  the  tibia,  and  one  third  of  the  fibula,  below 
the  popliteus,  and  is  inserted  with  the  two  fore- 
going muscles  by  a strong  tendon  into  the  upper 
and  back  part  of  the  os  calcis.  This  muscle  only  ex- 
tends the  tarsus. 

Tibialis  anticus  arises  from  the  upper  and  ex- 
terior part  of  the  tibia,  and  is  inserted  laterally 
into  the  os  cuneiforme  majus  of  the  tarsus,  and  by 
a small  portion  of  its  tendon  into  the  metacarpal 
bone  of  the  great  toe.  This  bends  and  turns  the 
tarsus  inward. 

Tibialis  posticus  arises  first  by  a small  begin- 
ning from  the  upper  part  of  the  tibia  between  that 
bone  and  the  fibula,  then  passing  between  the 
bones  through  a perforation  in  the  transverse  liga- 
ment which  connects  those  bones,  it  takes  other  be- 
ginnings from  the  upper  and  middle  part  of  the  ti- 
bia, and  from  the  middle  of  the  fibula,  and  the 
ligament  betwixt  the  tibia  and  fibula  ; then  grow- 
ing a round  tendon,  passes  under  the  inner  ancle, 
and  is  inserted  into  the  lower  part  of  the  os  navicu- 
lare,  and  into  the  os  cuneiforme  majus.  This  ex- 
tends and  turns  inward  the  tarsus. 

Peroneus  longus  arises  from  the  upper  and 
outer  part  of  the  fibula,  and  growing  a tendon  to- 
ward the  lower  part  of  this  bone,  passes  under  the 
outer  ancle,  and  the  muscles  situated  on  the  bot- 


or  THE  MUSCLES. 


117 


tom  of  the  foot,  and  is  inserted  into  the  beginning 
of  the  metatarsal  bone  of  the  great  toe,  and  the 
os  cuneiforme  next  that  bone.  This  turns  the 
tarsus  outward,  and  directs  the  force  of  the  other 
extensors  of  the  tarsus  toward  the  ball  of  the  great 
toe. 

Peroneus  brevis  arises  from  the  middle  of  the 
fibula,  under  a part  of  the  former,  and  growing- 
tendinous,  passes  under  the  outward  ancle,  and  is 
inserted  into  the  beginning  of  the  upper  part  of 
the  os  metatarsi  of  the  little  toe,  and  sometimes 
bestows  a small  tendon  on  the  little  toe.  Its  use  is 
to  extend  the  tarsus,  and  turn  it  outward. 

These  two  last  muscles  riding  over  the  lower 
end  of  the  fibula,  are  often  the  cause  of  a sprain  in 
the  outer  ancle,  when  they  are  vehemently  exert- 
ed to  save  a fall. 

Extensor  pollicis  longus  arises  from  the  upper 
and  middle  part  of  the  fibula  and  the  ligamentum 
transversale,  and  soon  becoming  a strong  tendon, 
is  inserted  into  the  last  bone  of  the  great  toe. 
This  also  bends  the  tarsus  with  a much  longer 
lever  than  it  extends  the  toe. 

Extensor  pollicis  brevis  arises  from  the  fore  part 
of  the  os  calcis,  and  is  inserted  into  the  same  place 
with  the  former. 

Flexor  pollicis  longus  arises  from  the  fib- 
ula, opposite  to  the  extensor  longus,  and  then 
passing  under  the  inner  ancle,  is  inserted  into  the 
under  side  of  the  last  bone  of  the  great  toe.  This 


118 


OF  THE  MUSCLES. 


extends  the  tarsus  at  a longer  lever  than  it  bends 
the  toe. 

Flexor  brevis  and  adductor  pollicis  are  the  same 
muscle,  arising  from  the  two  lesser  ossa  cuneiformia. 
and  os  cuboides  and  calcis.  They  are  inserted 
into  the  ossa  sesamoidea,  which  are  tied  by  a 
ligament  to  the  first  bone  of  the  great  toe,  reckon- 
ing only  two  bones  to  the  great  toe.  These  mus- 
cles bend  the  great  toe. 

Abductor  pollicis  arises  pretty  largely  from 
the  inner  and  back  part  of  the  os  calcis,  and  by 
a smaller  beginning  from  the  os  naviculare  ; 
thence  passing  forward  contiguous  to  the  os  cu- 
neiforme  majus,  passes  by  the  external  sesamoid 
bone  of  the  great  toe  to  its  insertion  into  the  first 
bone  of  the  great  toe.  This  muscle  is  less  an  ab- 
ductor than  a flexor  pollicis  pedis  ; it  also  very 
much  helps  to  constrict  the  foot  lengthways. 

Transversalis  pedis  arises  from  the  lower  end  of 
the  metatarsal  bone  of  the  toe  next  the  least,  and 
is  inserted  into  the  internal  sesamoicl  bone.  This 
truly  is  an  adductor  of  the  great  toe,  and  helps  to 
keep  the  constricture  of  the  bottom  of  the  foot. 

Extensor  digitorum  pedis  longus  arises  acute 
from  the  upper  part  of  the  tibia,  and  from  the 
upper  and  middle  part  of  the  fibula  and  ligament 
between  these  bones  ; then  dividing  into  five 
tendons,  four  of  them  are  inserted  into  the  second 
bone  of  each  lesser  toe,  and  the  fifth  into  the  be- 
ginning of  the  metatarsal  bone  of  the  least  toe,  and 


er  THE  MUSCLES. 


119 


sometimes  by  a small  tendon  also  into  the  little  toe. 
This  last  portion  for  the  most  part  is  separate  from 
its  beginning,  and  may  be  accounted  a distinct  mus- 
cle. The  four  first  tendons  only  of  this  muscle  ex- 
tend the  toes,  but  all  five  bend  the  tarsus,  and  that 
with  a longer  lever  than  any  of  them  bend  a toe. 

Extensor  digitorum  brevis,  arises  together 
with  the  extensor  pollicis  brevis,  from  the  os  cal- 
cis,  and  dividing  into  three  small  tendons  is  insert- 
ed into  the  second  joint  of  the  three  toes  next 
the  great  one.  The  long  extensors  of  the  toes  serve 
not  only  to  extend  them,  but  also  contribute  to 
the  bending  of  the  ancle,  which  motions  are  usu- 
ally performed  together  in  progression  ; but  the 
short  extensors  arising  below  the  ancle,  extend  the 
toes  only  ; and  when  the  long  extensors  are  em- 
ployed for  that  action  only,  the  extensors  of  the 
tarsus  must  act  at  the  same  time,  to  prevent  the 
bending  of  the  ancle.  This  is  the  reason  why  the 
toes  have  need,  though  their  motions  are  less,  of 
more  extensors  than  the  fingers. 

Flexor  brevis  or  perforatus  arises  from  the 
under  and  back  part  of  the  os  calcis,  thence  pass- 
ing toward  the  four  lesser  toes,  divides  into  four 
tendons,  which  are  inserted  into  the  beginning  of 
the  second  bone  of  each  of  the  lesser  toes.  These 
tendons  are  divided  to  let  through  the  tendons  of 
the  following  muscles. 

Flexor  longus  or  perforans  arises  from  the 
back  part  of  the  tibia,  above  the  insertion  of 


120 


OF  THE  MUSCLES. 


the  popliteus,  and  part  of  the  fibula  ; thence  de- 
scending under  the  os  calcis  to  the  bottom  of  the 
foot,  there  becomes  tendinous,  often  crosses,  and, 
in  most  bodies,  communicates  with  the  flexor  Ion- 
gus  pollicis  pedis  ; then  it  divides  into  four  ten- 
dons which  pass  through  those  of  the  flexor  brevis, 
and  are  inserted  into  the  third  bone  of  the  four 
lesser  toes.  This  muscle  also  extends  the  tarsus. 
The  second  beginning  of  this  muscle  arises  from  the 
os  calcis,  and  joins  the  tendons  where  they  divide. 
This  portion  only  bends  the  toes  : and  seeing  the 
flexor;  longus  of  the  toes  will,  when  it  acts  alone, 
extend  the  tarsus  as  well  as  bend  the  toes,  this 
portion,  like  the  short  extensors  of  the  toes,  seems 
purposely  contrived  to  bend  the  toes  alone. 

Lumbricales  arise  from  the  tendons  of  the  per- 
forans,  and  are  inserted  into  the  first  bone  of  each 
of  the  lesser  toes  which  they  bend. 

Abductor  minimi  digiti  pedis  arises  by  the  per- 
foratus  from  the  os  calcis,  and  being  part  of  it  in- 
serted into  the  metacarpal  bone  of  the  least  toe,  it 
receives  another  beginning  from  the  os  cuboides, 
and  is  inserted  into  the  first  bone  of  the  least  toe, 
which  it  bends  and  pulls  outward,  and  very  much 
helps  to  constrict  the  bottom  of  the  foot. 

Abductor  secundus  minimi  digiti  arises  under 
the  former  muscle  from  the  metatarsal  bone,  and  is 
inserted  into  the  little  toe. 

Interossei  are  seven  muscles  which  lie  like 
those  of  the  hands,-  and  arise  like  them  from  the 


OF  THE  MUSCLES. 


121 

metatarsal  bones,  and  are  inserted  like  them  into 
the  last  joints  of  the  four  lesser  toes  ; and  being  in 
their  progress  attached  to  the  tendons  1 which  ex- 
tend the  second  joints  of  the  toes,  they  will  extend 
both  these  joints.  These  muscles  may  be  fitly  di- 
vided into  external  and  internal  ; the  internal  also 
bend  the  first  joints,  as  do  all  the  interossei  in  the 
hand,  but  here  the  outer  ones  extend  the  first  joints  ^ 
and  if  we  consider  that  the  first  of  these  muscles  is 
analogous  to  the  abductor  indicis  of  the  hand,  and 
that  the  abductor  minimi  is  alike  in  both,  we  find 
that  the  muscles  to  move  the  fingers  and  lesser 
toes  sideways  are  alike  in  number,  though  this  mo- 
tion of  the  toes  is  in  a manner  lost  from  the  use  of 
shoes.  The  muscles  that  bend  or  extend  the  last 
joints  of  the  toes  will  also  move  the  second  and 
first,  and  those  that  move  the  second  will  also 
move  the  first,  as  they  do  ija  the  fingers. 


122 


TABLES. 


TABLE  XL 

1 Musculus  frontalis. 

2 Temporalis. 

3 Orbicularis. 

4 The  parotid  gland,  with  its  duct,  which  passes* 

through  the  buccinator. 

5 Mastoideus. 

6 Zygomaticus. 

7 Elevator  labii  superioris  proprius. 

8 Elevator  labiorum  communis. 

9 Depressor  labiorum  communis. 

10  Sphincter  oris. 

1 1 Depressor  labii  inferioris  proprius. 

12  Buccinator. 

13  Sterno-hyoidei. 

14  Coraco-hyoideus. 

15  Mastoideus. 

16  Trapezius. 

17  Pectoralis. 

18  Deltoides. 


'' 


TAB. XL 


JP-12,2,. 


'CAB.XIC. 


tabi.es. 


TABLE  XIL 

1 Musculus  mastoideus. 

2 Pectoralis. 

3 Biceps  flexor  cubitL 

4 Coraco-brachialis. 

5 Triceps  extensor  cubitL 

6 Latissimus  dorsL 

y Serator  major  anticus, 

8 Obliquus  descendens  abdominis? 

9 Rectus  abdominis. 

10  Pyramidalis. 

11  Sartorius. 

12  Fascialis. 

13  Rectus  femoris. 


124 


TABLES. 


TABLE  XIII. 

1 Trapezius. 

2 Deltoides. 

3 Infraspinatus  scapulae. 

4 Teres  major. 

5 Rhomboides. 

6 Latiksimus  dorsi. 

7 Glutaei. 

8 Obliquus  descendens  abdominis. 


i 


T,\B.Xni. 


-P.  jst4 


TAB-XIV. 


TABLES. 


125 


TABLE  XIV. 

1 Musculus  deltoides. 

2 Triceps  extensor  cubiti. 

3 Anconseus. 

4 Extensor  carpi  radialis  primus. 

5 Extensor  carpi  radialis  secundus. 

6 Extensor  carpi  ulnaris. 

7 Flexor  carpi  ulnaris. 

8 Deltoides. 

9 Biceps  flexor  cubiti. 

10  Brachiaeus  internus. 

11  Triceps  extensor  cubiti. 

12  Supinator  radii  longus. 

13  Extensores  carpi  radiales. 

14  Extensor  communis  digitorum. 

15  Extensor  carpi  ulnaris. 

16  Flexor  carpi  ulnaris. 

17  Anconseus. 

18  Extensor  pollicis  primus. 

19  Extensor  pollicis  secundus. 


126 


TABLES- 


TABLE  XV. 

1 Musculus  deltoides. 

2 Pectoralis. 

3 Biceps  flexor  cubiti. 

4 Triceps  extensor  cubiti. 

5 The  fascia  tendinosa  of  the  biceps  muscle. 

6 Supinator  radii  longus. 

7 Flexor  carpi  radialis. 

8 Glutseus. 

9 Vastus  externus. 

10  Biceps  femoris. 

11  Semitendinosus. 

12  Semimembranosus. 

13  Gastrocnemius. 

14  Solaeus. 


TABLES. 


12 


TABLE  XVL 

1 Musculus  rectus  femoris. 

2 Vastus  externus. 

3 Vastus  internus, 

4 Sartorius. 

5 Pectinaeus. 

6 The  large  head  of  the  triceps, 
,7  Gastrocnemius. 

8 Solaeus. 

9 Membranosus. 

10  Rectus  femoris. 

11  Vastus  internus. 

12  Vastus  externus. 

13  Sartorius. 

14  Pectinaeus. 

15  Gastrocnemius. 

16  Solaeus. 

17  Tibialis  anticus. 

18  Extensores  digitorum 


128 


tabIes* 


TABLE  XVII, 

1 Musculus  abductor  pollicis. 

2 Adductor  pollicis. 

3 Flexor  brevis. 

4 Quadratus  seu  palmaris  brevis. 

5 The  strong  ligament  of  the  carpus  that  binds 
down  the  tendons  of  the  flexors  of  the  fingers. 

6 Abductor  minimi  digiti. 

7 A probe  under  the  tendons  of  the  perforatus. 

8 A probe  under  the  tendons  of  the  perforans. 

9 Lumbricales. 

10  Perforatus. 

11  Flexor  carpi  radialis. 

12  Flexor  carpi  ulnaris. 


TAB.XYir. 


P.  ;z8. 


TAB.WflL 


TABLES. 


129 


TABLE  XVIIL 

1 Tendo  achilles. 

2 That  part  of  the  astragalus  which  articulates 

with  the  tibia. 

3 The  tendon  of  the  tibialis  anticus. 

4 The  tendon  of  the  extensor  pollicis  pedis  longus, 

5 The  tendons  of  the  extensor  digitorum  com- 

munis. 

6 Extensor  pollicis  pedis  brevis. 

7 Extensor  digitorum  brevis. 

8 The  union  of  the  tendons  of  the  extensor  lortgus 

and  the  extensor  brevis. 


130 


TABLES. 


TABLE  XIX. 

1 Musculus  triceps  extensor  cubitL 

2 Deltoides. 

3 Teres  major. 

4 Latissimus  dorsi. 

5 Pectoralis. 

6 Obliquus  descendens  abdominis. 

7 Rectus  abdominis. 

8 Sartorius. 

9 Rectus  femoris. 

10  Vastus  externus. 

11  Vastus  internus. 

12  Gastrocnemius. 

13  Solaeus. 

14  Tibialis  anticus. 


TAE.XIX. 


130  ■ 


- 4 


TAB . XX . 


P.  isi . 


TABLES, 


131 


TABLE  XX. 

This  table  is  done  after  the  famous  statue  of 
Hercules  and  Antaeus.  The  muscles  here  exhib- 
ited being  all  explained  in  the  other  plates,  the 
figures  are  omitted  to  preserve  the  beauty  of  the 
plate. 


THE 


ANATOMY 


OF  THE 


HUMAN  BODY. 


BOOK  III. 


CHAPTER  I. 

OF  THE  EXTERNAL  PARTS,  AND  COMM0N  IN- 
TEGUMENTS. 

Tm  vulgar  names  of  the  external  parts 
of  the  human  body  being  sufficiently  known 
for  the  description  of  any  disease  or  operation  5 I 
shall  only  describe  those  which  anatomists  have 
given  for  the  better  understanding  of  the  sub-con- 
tained parts. 

The  hollow  on  the  middle  of  the  thorax,  under 
the  breasts,  is  called  scrobiculus  cordis  ; the  middle 
of  the  abdomen  for  about  three  fingers  breadth 


134 


EXTERNAL  PARTS,  &C. 

above  and  below  the  navel,  is  called  regio  um- 
bilicalis  ; the  middle  part  above  this,  epigas- 


cartilages  of  the  lower  ribs,  hypocondrium  ; and 
from  below  the  regio  umbilicalis,  down  to  the  ossa 
ilia  and  ossa  pubis,  hypogastrium. 

Caticula,  or  scarf-skin,  is  that  thin  insensible 
membrane  which  is  raised  by  blisters  in  living 
bodies.  It  is  extended  over  every  part  of  the  true 
skin,  unless  where  the  nails  are.  It  appears  to  me 
in  a microscope  a very  fine  smooth  membrane,  only 
unequal  where  the  reticulum  mucosum  adheres 
to  it.  Lewenhoeck,  and  others,  say  it  appears 
scaly,  and  compute  that  a grain  of  sand  of  the 
hundreth  part  of  an  inch  diameter,  will  cover 
two  hundred  and  fifty  of  these  scales,  and  that  each 
scale  has  about  five  hundred  pores  ; so  that  a grain 
of  sand  will  cover  125,000  pores  through  which 
we  perspire.  Its  use  is  to  defend  the  true  skin  that 
it  may  not  be  exposed  to  pain  from  whatever  it 
touches  ; and  also  to  preserve  it  from  wearing ; 
it  is  thickest  on  those  parts  of  the  bottom  of  the 
foot  which  sustain  the  body,  and  in  hands  much 
used  to  labour,  being  so  contrived  as  to  grow  the 
thicker  the  more  those  parts  are  used.  In  scorbu- 
tic disorders  the  cuticula  will  sometimes  become 
scurfy  and  full  of  little  ulcers,  which  are  apt  to 
remain  even  when  the  cause  is  taken  away,  but  the 
cuticle  being  taken  oft  by  a blister,  the  new  cuti-c 
cle  will  be  sound  ; and  though  the  cutis  is  affected, 


135 


EXTERNAL  parts,  &c. 

and  full  of  little  tumors,  the  discharge  of  the  blis- 
ter will  often  cure  them  also. 

Between  this  and  the  true  skin  is  a small 
quantity  of  slimy  matter,  which  was  supposed  by 
Malpighi  and  others,  to  be  contained  in  proper 
vessels,  interwoven  with  one  another,  and  there- 
fore by  them  named  reticulum  mucosum.  It  is 
most  considerable  where  the  cuticula  is  thickest, 
and  is  black,  white,  or  dusky,  such  as  is  the  com- 
plexion ; the  colour  of  this  and  the  cuticula  being 
the  only  difference  between  Europeans  and  Afri- 
cans or  Indians,  the  fibres  of  the  true  skin  being 
white  in  all  men  ; but  the  florid  colour  of  the 
cheeks  is  owing  to  the  blood  in  the  minute  vessels 
of  the  skin,  as  that  in  the  lips  to  the  vessels  in  the 
muscular  flesh  ; for  the  cuticula  being  made  of 
excrementitious  matter,  has  no  blood  vessels. 

Cutis,  or  true  skin,  is  a very  compact,  strong, 
and  sensible  membrane,  extended  over  all  the 
other  parts  of  the  body,  having  nerves  terminat- 
ing so  plentifully  in  all  its  superficies,  for  the 
sense  of  touching,  that  the  finest  pointed  instru- 
ment can  prick  no  where  without  touching  some 
of  them.  These  nerves  are  said  by  Malpighi 
and  others,  who  have  examined  them  carefully,  to 
terminate  in  small  pyramidal  papilke  ; nevertheless, 
it  seems  that  a plain  superficies  of  the  skin  is  much 
fitter  and  more  agreeable  to  what  we  experience  of 
this  sensation  ; for  a plain  superficies  exposing  all 
the  nerves  alike,  I think,  would  give  a more  equal 


136  EXTERNAL  PARTS,  &C. 

sensation,  while  nerves  ending  in  a pyramidal  pa- 
pilla would  be  exceeding  sensible  at  the  vertex  of 
that  papilla  ; and  those  at  the  sides  and  round  the 
base,  which  would  be  far  the  greatest  part,  would 
be  the  least  useful.  Immediately  under  the  skin 
upon  the  shin  bone,  I have  twice  seen  little  tumors 
less  than  a pea,  round  and  exceeding  hard,  and  so 
painful  that  both  cases  were  judged  to  be  cancerous  ; 
they  were  cured  by  extirpating  the  tumor : but 
what  was  more  extraordinary,  was  a tumor  of  this 
kind,  under  the  skin  of  the  buttock,  small  as  a 
pin’s  head,  yet  so  painful  that  the  least  touch 
was  insupportable,  and  the  skin  for  half  an  inch 
round  was  emaciated ; this  too  I extirpated,  with 
so  much  of  the  skin  as  was  emaciated,  and  some 
fat.  The  patient,  who  before  the  operation  could 
not  endure  to  set  his  leg  to  the  ground,  nor  turn 
in  his  bed  without  exquisite  pain,  grew  immediately 
easy,  walked  to  his  bed  without  any  complaint,  and 
was  soon  cured. 

Glanduke  miliares  are  small  bodies  like  mil- 
let seeds,  seated  immediately  under  the  skin  in  the 
axillas  ; and  are  said  to  have  been  found  under  all 
other  parts  of  the  skin,  where  they  have  been 
looked  for  with  microscopes.  These  glands  are 
supposed  to  separate  sweat ; which  fluid  was  thought 
to  be  only  the  materia  perspirabilis  flowing  in  a 
greater  quantity,  and  condensed,  till  San c torius 
assured  us  that  it  is  not  so,  and  that  more  of  the 
materia  perspirabilis  is  separated  in  equal  times  than 


137 


external  parts,  &c. 

of  sweat  ; of  the  former,  he  says,  usually  fifty-two 
ounces  a day  in  Italy,  where  his  experiments  were 
made,  and  of  the  latter  not  near  so  much  in  the 
most  profuse  sweats  ; which  seems  to  favour  the 
opinion  of  the  existence  of  these  glands  : but  who- 
ever reads  Mr.  Hales’s  experiments  will  find, 
that  what  Sanctorius  accounted  for  by  an 
imaginary  insensible  perspiration,  different  from 
that  which  in  the  greatest  degree  produces  sweat, 
is  really  made  by  the  lungs  in  respiration,  and  is 
ten  times  more  than  all  the  ordinary  perspiration 
through  the  cutis,  and  seems  to  be  but  the  same 
kind  of  fluid  discharged  both  ways  ; for  whenever 
it  is  interrupted  through  the  skin  in  cold  weather, 
then  the  lungs  are  overcharged,  which  occasions  i**2 
coughing  to  get  rid  of  it,  which  in  a greater 
degree  is  an  asthma.  Hence  too  it  is,  that  those 
who  perspire  most  in  the  summer  are  most  sub- 
ject to  asthmatic  disorders  in  the  winter  ; and  most 
of  all  so,  when  the  air  they  breathe  is  fullest  of 
vapour,  and  therefore  least  capable  of  conveying 
this  matter  from  the  lungs.  That  this  kind  of 
perspiration  is  very  great,  is  sufficiently  shewn  by 
breathing  upon  glass,  or  any  thing  that  is  smooth 
and  cold. 

Membrana  adiposa  is  all  that  membrane  imme- 
diately under  the  skin,  which  contains  the  fat 
in  cells ; it  is  thickest  on  the  abdomen  and  but- 
tocks, and  thinnest  nearest  the  extremities  ; and 
where  the  muscles  adhere  to  the  skin,  and  on  the 


T 


138 


EXTERNAL  PARTS,  &C, 

penis,  little  or  none.  It  contributes  to  keep  tke  in 
ncr  parts  warm,  and  by  filling  the  interstices  of 
the  muscles,  renders  the  surface  of  the  body  smooth 
and  beautiful,  and  may  serve  to  lubricate  their  sur- 
faces. Whether  the  decrease  of  fat,  which  often 
follows  labour  or  sickness,  proceeds  from  its  being 
reassumed  into  the  blood  vessels,  or  whether  it  is 
constantly  perspiring  through  the  skin,  and  the 
lessening  of  its  quantity  is  from  the  want  of  a sup- 
ply equal  to  its  consumption,  is  with  me  a matter 
of  doubt,  though  the  former  opinion,  I know,  gen- 
erally prevails.  The  cells  of  this  membrane  com- 
municate throughout  the  whole  body  so  much, 
that  from  any  one  part  the  whole  may  be  filled 
with  air.  I have  seen  two  cases  where  the  wind- 
pipe being  cut,  and  the  external  wounds  being 
closely  stitched  by  injudicious  surgeons,  the  air 
that  escaped  at  the  wound  of  the  wind-pipe  get- 
ting into  the  cells  of  the  membran-a  adiposa,  blew 
up  the  upper  part  of  the  body  like  a bladder. 
The  like  accident  I have  seen  from  a broken  rib, 
where,  I suppose,  the  end  of  the  rib  had  pricked 
the  lungs ; all  these  persons  died.  In  these  cells 
the  water  is  contained  in  an  anasarca,  which  from 
its  weight,  first  fills  the  depending  parts,  as  the 
air  in  the  former  cases  did  the  upper  parts  ; and 
when  these  cells  are  very  full,  the  water  frequently 
passes  from  them  into  the  abdomen,  and  after 
tapping,  though  the  limbs  were  ever  so  full, 
they  will  almost  empty  themselves  in  one  night’s 


EXTERNAL  PARTS,  &C.  139 

time.  This  membrane  is  the  usual  seat  of  im= 
posthumations  and  boils,  in  both  which  nature, 
uninterrupted,  always  corrodes  a hole  in  the  skin ; 
from  whence  we  may  learn,  that  the  best  way  of 
opening  any  imposthumation  is  by  a hole,  and  that 
too  as  near  the  time  of  its  breaking  naturally  as 
may  be,  that  nature  may  make  the  utmost  ad- 
vantage of  the  discharge.  There  is  sometimes  a 
large  kind  of  boil  or  carbuncle  in  this  membrane, 
which  first  makes  a large  slough  and  a number  of 
small  holes  through  the  skin,  which  in  time  mor- 
tifies and  casts  off,  but  the  longer  the  slough  is 
suffered  to  remain,  the  more  it  discharges,  and  the 
more  advantage  to  the  patient ; at  the  latter  end  of 
which  case  the  matter  has  a bloody  tincture,  and  a 
bilious  smell,  exactly  like  what  comes  from  ulcers 
in  the  liver  ; and  both  these  cases  are  attended  with 
sweet  urine,  as  in  a diabetes. 

Mammae,  the  breasts,  seem  to  be  of  the  same 
structure  in  both  sexes,  but  largest  in  women. 
Each  breast  is  a conglomerate  gland  to  separate 
milk,  with  its  excretory  ducts  ; which  are  capable 
of  very  great  distention,  tending  toward  the  nipple, 
which  as  they  approach,  they  unite,  and  make  but 
a few  ducts  at  their  exit.  There  are  to  be  met 
with  in  authors  instances  attested  of  men  mvina: 
suck,  when  they  have  been  excited  by  a vehement 
desire  of  doing  it  and  it  is  a common  observation, 
that  milk  will  flow  out  of  the  breasts  of  new-born 
children,  both  male  and  female. 


140  EXTERNAL  PARTS,  &C. 

The  breasts  and  uterus  in  women,  the  tongue, 
mouth,  and  penis  in  men,  and  the  eyes  in  chil- 
dren, are  the  parts  most  subject  to  cancers ; yet 
there  is  no  part  where  this  disease  has  not  some- 
times fixed.  It  is  a matter  of  dispute  among  some 
surgeons,  whether  cancerous  tumours  should  ever  be 
extirpated  or  not,  though  it  is  certain  none  of  these 
ever  were  cured  without,  and  being  extirpated, 
there  have  been  many.  The  objection  against  ex- 
tirpation is  this,  that  the  operation  often  provokes 
the  part,  which  otherwise  might  lie  quiet  : but  I 
do  not  think  this  is  true  ; in  desperate  cases,  where 
we  cannot  extirpate,  we  find  the  best  remedy  is 
plentiful  bleeding,  (which  also  is  nature’s  last  resort) 
gentle  constant  evacuations  by  stool,  and  a vegeta- 
ble diet ; and  though  physic  never  cures  while  the 
tumour  remains,  yet  after  extirpation  it  is  highly 
useful,  and  even  the  worst  constitutions  have  some- 
times been  brought  to  their  primitive  state.  An 
eminent  surgeon  in  the  city,  having  a patient  with 
a cancerated  breast,  extremely  large,  and  so  much 
ulcerated  that  the  stench  of  it  was  insupportable ; 
she  insisted  upon  the  extirpation,  against  all  advice, 
with  no  other  hopes  but  to  be  delivered  from  the 
offensive  smell.  Some  time  after  the  operation,  the 
wound  looking  extremely  sordid,  he  sprinkled  it 
all  over  with  red  mercury  precipitate,  which  put 
the  patient  into  a high  salivation,  upon  which  the 
breast  grew  clean  and  healed,  the  patient  recover- 
ed, and,  contrary  to  all  expectation,  lived  many 


membranes  in  general. 


141 


years  in  good  health.  From  this  accident  I learnt 
the  usefulness  of  salivating,  after  extirpating  can- 
cerous tumours,  though  nothing  is  more  hurtful  be- 
fore. In  the  extirpation  of  a breast,  and  all  other 
tumours,  as  much  skin  as  is  possible  should  be  sav- 
ed ; for  the  loss  of  a great  deal  of  skin  is  sufficient 
to  make  an  incurable  ulcer  in  the  most  healthful 
body,  and  much  more  so  in  a bad  constitution. 


CHAPTER  II. 

OF  THE  MEMBRANES  IN  GENERAL. 

Every  distinct  part  of  the  body  is  covered, 
and  every  cavity  is  lined  with  a single  mem- 
brane, whose  thickness  and  strength  is  as  the  bulk 
of  the  part  it  belongs  to,  and  as  the  friction  to 
which  it  is  naturally  exposed. 

Those  membranes  that  contain  distinct  parts, 
keep  the  parts  they  contain  together,  and  render 
their  surfaces  smooth,  and  less  subject  to  be  lace- 
rated by  the  actions  of  the  body ; and  those  which 
line  cavities  serve  to  render  the  cavities  smooth,  and 
fit  for  the  parts  they  contain  to  move  against. 

The  membranes  of  all  the  cavities  that  contain 
solid  parts,  are  studded  with  glands,  or  are  provided 
with  vessels,  which  separate  a mucus,  to  make  the 
parts  contained  move  glibly  against  one  another, 
and  not  grow  together  ; and  those  cavities  which 
are  exposed  to  the  air,  as  the  nose,  ears,  mouth. 


142 


SALIVARY  GLANDS. 


and  trachea  arteria,  have  their  membranes  beset 
with  glands  which  separate  matter  to  defend  them 
from  the  outer  air.  Those  membranes  that  have 
proper  names,  and  deserve  a particular  description, 
will  be  treated  of  in  their  proper  places. 


CHAPTER  III. 

OF  THE  SALIVARY  GLANDS. 

Parotis,  or  maxillaris  superior,  is  the  larg- 
est  of  the  salivary  glands  ; it  is  situate  behind 
the  lower  jaw,  under  the  ear  ; its  excretory  duct 
passes  over  the  upper  part  of  the  masseter  mus- 
cle, and  enters  the  mouth  through  the  bucci- 
nator. This  gland  has  its  saliva  promoted  by  the 
motions  of  the  lower  jaw.  Its  duct  passes  over  the 
tendinous  part  of  the  masseter  muscle,  that  it  may 
not  be  compressed  by  that  muscle,  which  would 
obstruct  the  saliva  in  it,  though  it  is  frequently  said 
that  it  passes  over  that  muscle  that  it  may  be  com- 
pressed by  it,  to  promote  the  saliva.  In  sheep, 
horses,  &c.  whose  jaws  are  long,  this  muscle  is  in- 
serted far  from  the  centre  of  motion,  that  the  end 
of  the  jaw  may  be  moved  with  sufficient  strength, 
and  that  distant  insertion  requiring  a greater  length 
of  muscle,  that  its  motion  may  be  quick  enough, 
no  part  of  this  muscle  could  be  allowed  to  be  ten- 
dinous ; therefore,  it  seems,  to  avoid  the  inconve- 


SALIVARY  GLANDS. 


143 


r 


nience  of  compression  from  the  muscle,  the  duct  in 
those  animals  goes  quite  round  the  lower  end  of  it. 
When  this  duct  is  divided  by  an  external  wound, 
the  saliva  will  flow  out  on  the  cheek,  unless  a con- 
venient perforation  be  made  into  the  mouth,  and 
then  the  external  wound  may  be  healed.  I have 
seen  patients  with  this  gland  ulcerated,  from  which 
there  was  a constant  effusion  of  saliva,  till  the 
greatest  part  of  the  gland  was  consumed  with  red 
mercury  precipitate  ; and  then  they  healed  with  little 
trouble.  Hildanus  mentions  the  same  case,  which 
for  two  years  had  been  under  the  care  of  a surgeon 
without  success  ; and  was  at  last  cured  by  the  ap- 
plication of  an  actual  cautery. 

Maxillaris  inferior  is  situate  between  the  low- 
er jaw  and  the  tendon  of  the  digastric  muscle. 
Its  duct  passes  under  the  musculus  mylohyoideus, 
and  enters  the  mouth  under  the  tongue,  near  the 
dentes  incisorii.  I was  at  the  opening  of  a woman 
who  was  suffocated  by  a tumour  which  begun  in  this 
gland,  and  extended  itself  from  the  sternum  to  the 
parotid  gland  on  one  side  in  six  weeks  time,  and  in 
nine  weeks  killed  her  ; it  was  a true  scirrhus,  and 
weighed  twenty  six  ounces.  In  a man  which  I 
dissected,  I found  a quantity  of  pus  near  this  gland, 
and  a bundle  of  matter  not  unlike  hair,  as  large  as 
an  hen’s  egg. 

Sublingualis  is  a small  gland  situated  under  the 
tongue,  between  the  jaw  and  the  seratoglossus 
muscle.  In  a calf  I found  several  ducts  of  this 


144 


SALIVARY  GLANDS'. 


gland  filled  by  an  injection  into  the  duct  of  the 
submaxillary  gland  ; but  Morgagni  and  others 
shew,  that  the  ducts  of  this  gland  enter  the  mouth 
directly  from  the  gland  in  several  places  near  the 
grinding  teeth. 

Tonsilla  is  a globular  gland,  about  the  bigness 
of  a hazel  nut,  situate  upon  the  pterygoideus  in- 
ternus  muscle,  between  the  root  of  the  tongue  and 
the  uvula.  It  has  no  duct  continued  from  it,  but 
empties  all  its  small  ducts  into  a sinus  of  its  own, 
which  sinus,  when  the  gland  is  inflamed,  may  ea- 
sily be  mistaken  for  an  ulcer.  This  gland  with  its 
fellow  direct  the  masticated  aliment  into  the  pha- 
rynx, and  also  serve  for  the  uvula  to  shut  down 
upon  when  we  breathe  through  the  nose.  They  are 
compressed  by  the  tongue  and  the  aliment,  when 
the  former  raises  the  latter  over  its  root,  and  there*- 
by  opportunely  emit  their  saliva  to  lubricate  the 
food  for  its  easier  descent  through  the  pharynx.  A 
scirrhous  tumour  of  either  of  these  glands  is  a com- 
mon disease,  and  it  admits  of  no  remedy  but  ex- 
tirpation. The  best  way  of  extirpating  them,  is, 
I think,  by  ligature : if  the  gland  is  small  at  its 
basis,  the  ligature  may  be  tied  round  it,  which  I 
have  often  performed  by  fixing  the  ligature  to  the 
end  of  a probe  bent,  and  so  drew  it  round  the 
gland,  and  tied  it ; and  in  a few  days  the  glands 
dropped  off : but  meeting  with  other  cases  of  this 
kind,  where  the  basis  of  the  gland  was  too  large  to 
tie,  I contrived  an  instrument  like  a crooked  needle 


SALIVARY  GLANDS. 


145 


set  in  a handle,  with  an  eye  near  the  point ; I thrust 
this  instrument,  with  a ligature  into  it  through  the 
bottom  of  the  gland,  and  then  taking  hold  of  the 
ligature  with  a hook,  I drew  back  the  instrument  ; 
then  drawing  the  double  ligature  forwards,  I divid- 
ed it,  and  tied  one  part  above  and  the  other  below, 
in  the  same  manner  that  I did  to  extirpate  part  of 
the  omentum  in  the  cure  of  an  hernia,  and  this 
succeeded  as  well  as  the  former.  See  the  plate  at 
the  latter  end  of  this  book. 

Pressure  upon  the  surface  of  a gland  very 
much  promoting  the  secretion  that  is  made  in  it, 
these  glands  are  so  seated  as  to  be  pressed  by  the 
lower  jaw,  and  its  muscles,  which  will  be  chiefly 
at  the  time  when  the  fluid  is  wanted ; and  the 
force  with  which  the  jaw  must  be  moved,  being 
as  the  dryness  and  hardness  of  the  food  masticated, 
the  secretion  from  the  glands  depending  very  much 
upon  that  force  ; it  will  also  be  in  proportion  to  the 
dryness  and  hardness  of  that  food  which  is  necessa- 
ry ; for  all  food,  being  to  be  reduced  to  a pulp, 
by  being  broke  and  mixed  with  saliva,  before  it 
can  be  swallowed  fit  for  digestion,  the  drier  and 
harder  foods  needing  more  of  this  matter,  will  from 
this  mechanism  be  supplied  with  more  than  moist- 
er  foods  in  about  that  proportion  in  which  they 
are  drier  and  harder  ; and  the  drier  foods  needing 
more  saliva  than  moister,  is  the  reason  why  we 
can  eat  less,  and  digest  less  of  these  than  those. 
What  quantity  of  saliva  these  glands  can  separate 


u 


146 


SALIVARY  GLANDS. 


from  the  blood,  in  a given  time,  will  be  hard  to  de- 
termine, but  in  eating  of  dry  bread  it  cannot  be  less 
than  the  weight  of  the  bread  ; and  many  men, 
in  a little  time,  can  eat  more  dry  bread  than  twice 
the  size  of  all  these  glands  ; and  some,  that  are  not 
used  to  smoking,  can  spit  half  a pint  in  the  smok- 
ing one  pipe  of  tobacco ; and  some  men  in  a sali- 
vation, have  spit,  for  days  or  weeks  together,  a 
gallon  in  four  and  twenty  hours  ; and  yet,  I be- 
lieve, all  these  glands  put  together,  do  not  weigh 
more  than  four  ounces. 

The  membrane  which  lines  the  mouth  and  pal- 
ate, and  covers  the  tongue,  is  every  where  beset 
with  small  glands,  to  afford  saliva  in  all  parts  of 
the  mouth  to  keep  it  moist ; for  those  more  remote 
are  chiefly  concerned  in  time  of  mastication.  These 
small  glands  have  names  given  them  according  to 
their  respective  situations,  as  buccales,  labiales, 
linguales,  fauciales,  palatinse,  gingivarum,  and. 
uvulares. 

A gland  is  chiefly  composed  of  a convolution 
of  one  or  more  arteries  of  a considerable  length, 
from  whose  sides  arise  a vast  number  of  excretory 
ducts,  as  the  lacteals  arise  from  the  guts,  to  receive 
in  each  gland  their  proper  juices,  as  the  lacteals  do 
the  chyle  ; and  though  the  larger  secretions  are  made 
by  visible  glands,  yet  unconvolved  arteries  may  also 
have  excretory  ducts  for  the  same  purpose.  And 
this  way,  I imagine,  secretions  are  made  from  all 
the  membranes  that  line  cavities,  and  some  others. 


SALIVARY  GLANDS. 


147 


There  also  arise  from  these  arteries  lymphatic  ves- 
sels, whose  use  seems  to  be  to  take  off  the  thinnest 
part  of  the  blood,  where  a thick  fluid  is  to  be  se- 
creted, seeing  they  are  found  in  greatest  plenty  in 
such  glands  as  separate  the  thickest  fluids,  as  in 
the  testicles  and  liver  ; and  it  is  observable  that, 
where  the  thickest  secretions  are  made,  the  velocity 
of  the  blood  is  the  least,  as  if  it  was  contrived  to 
give  those  seemingly  more  tenacious  parts  more 
time  to  separate  from  the  blood.  The  arteries  that 
compose  different  glands  are  convolved  in  different 
manners ; but  whether  or  no  their  different  secre- 
tions depend  at  all  upon  that,  I doubt  will  be  dif- 
ficult to  discover.  The  excretory  ducts  arise  from 
the  arteries,  and  unite  in  their  progress,  as  the  roots 
of  trees  do  from  the  earth  ; and  as  different  trees, 
plants,  fruits,  and  even  different  minerals,  in  their 
growing,  often  derive  their  distinct}  proper,  nu- 
tritious juices  from  the  same  kind  of  earth  ; so  the 
excretory  ducts,  in  different  glands,  separate  from 
the  same  mass  of  blood  their  different  juices  : but 
what  these  different  secretions  depend  upon,  wheth- 
er the  structure  of  the  parts,  or  different  attrac- 
tions, or  what  else,  we  have  no  certainty  about, 
though  this  subject  has  employed  several  ingenious 
writers.  For  my  own  part,  from  the  great  simplic- 
ity and  uniformity  usually  seen  in  nature’s  works, 
I am  most  inclined  to  think  different  secretions 
arise  from  different  attractions,  seeing  that  in  plants 
and  minerals  there  seems  to  be  no  other  way. 


148 


PERITONAEUM, 


CHAPTER  IV. 

OF  THE  PERITONAEUM,  OMENTUM,  DUCTUS  ALI- 
MENT ALIS,  AND  MESENTERY. 

PERITONAEUM  is  a membrane  which  lines 
the  whole  cavity  of  the  abdomen.  It  contains 
the  liver,  spleen,  omentum,  stomach,  guts,  and 
mesentery,  with  all  their  vessels  and  glands ; the 
upper  part  of  it  is  no  other  than  the  proper  mem- 
brane of  the  diaphragm,  for  there  is  no  more  rea- 
son to  call  that,  part  of  the  peritonaeum,  than  there 
is  for  calling  the  membrane  on  the  other  side  of 
the  diaphragm,  part  of  the  pleura  or  mediastinum. 
The  fore  part  next  the  muscles  of  the  abdomen, 
and  their  tendons,  may  be  divided  into  two  lami- 
nae, yet,  I think,  anatomists  in  describing  the  du- 
plicature  or  laminae  of  the  peritonaeum  have  not 
always  meant  this  division,  but  have  taken  the  ten- 
dons of  the  transverse  muscles  for  the  outer  lamina, 
and  considered  the  other  as  one  membrane,  seeing 
that  it  is  between  these  tendons  and  the  peritonaeum 
that  the  water  is  found  in  that  kind  of  dropsy  which 
is  called  the  dropsy  in  the  dupiicature  of  the  peri- 
tonaeum. Upon  the  loins  the  inner  surface  only  is 
smooth,  and  the  outer  part  a sort  of  loose  membra- 
na  adiposa,  in  which  are  contained  the  aorta,  ve- 
na cava,  vasa  spermatica,  and  pancreas,  with  oth- 
er parts  of  less  note.  The  middle  of  the  perito- 
naeum upon  the  loins  is  joined  to  the  mesentery 


OMENTUM,  StC. 


149 


in  such  a manner,  as  makes  some  account  it  a pro- 
duction of  the  peritonaeum,  and  some  part  of  the 
external  membrane  of  the  duodenum,  becoming 
one  membrane  with  the  inner  or  smooth  lamina  of 
the  peritonaeum,  and  part  of  the  rectum  is  covered 
in  the  same  manner  ; but  the  kidneys  and  bladder 
of  urine  are  contained  in  a distinct  duplica'cure  of 
this  membrane.  The  dropsy  of  the  peritonaeum 
may  be  distinguished  by  being  least  prominent 
about  the  navel,  for  there  the  tendons  and  the 
peritonaeum  will  not  separate  ; and  the  water  in 
those  that  I have  dissected,  had  made  the  parts 
where  it  was  contained  as  foul  as  any  ulcer  ; 
therefore  none  of  them,  I presume,  could  have 
been  cured  by  operation. 

For  the  umbilical  vessels,  see  chap.  Of  the  foe- 
tus. For  the  processus  vaginalis,  chap.  Of  the 
parts  of  generation  in  men. 

Omentum,  or  caul,  is  a fine  membrane,  larded 
with  fat,  somewhat  like  net-work.  It  is  situ- 
ated on  the  surface  of  the  small  guts,  and  resem- 
bles an  apron  tucked  up  ; its  outer  or  upper  part, 
named  ala  superior,  is  connected  to  the  bottom 
of  the  stomach,  the  spleen,  and  part  of  the  in- 
testinum  duodenum ; and  thence  descending  a lit- 
tle lower  than  the  navel,  is  reflected  and  tied  to 
the  intestinum  colon,  the  spleen,  and  part  of  the  duo- 
denum ; this  last  part  is  called  ala  inferior  ; and  the 
space  between  the  ake  is  named  bursa.  This  cavi- 
ty is  very  distinct  in  most  brutes,  but  seldom  so  in 


150 


DUCTUS  ALIMENTALIS. 


men.  Sometimes  both  alae  are  tied  to  the  liver, 
and,  in  diseased  bodies,  to  the  peritonaeum.  Its  use 
is  to  lubricate  the  guts,  that  they  may  the  better 
perform  their  peristaltic  motion.  Malpighi  de- 
scribes adipose  ducts  in  this  membrane  to  carry  the 
fat  from  the  cells  into  the  vena  portae,  and  thinks 
it  a necessary  ingredient  in  the  bile.  In  dropsies  of 
the  abdomen,  and  in  persons  who  from  any  other 
cause  have  died  tabid,  it  is  generally  rotten  and  de- 
cayed ; and  sometimes  the  guts  in  these  cases  adhere 
to  one  another  : but  whether  these  adhesions  pro- 
ceed from  the  omentum’s  ceasing  to  perform  its  of- 
fice, or  from  the  peristaltic  motion  of  the  guts  being 
long  discontinued  through  abstinence,  or  both,  I 
cannot  determine. 

Ductus  alimentalis,  is  the  oesophagus,  stom- 
ach, and  guts,  viz.  duodenum,  jejunum,  ilium, 
colon,  caecum  or  appendicula  vermiformis,  and 
rectum. 

(Esophagus,  or  gullet,  is  the  beginning  of  the 
alimentary  duct  ; its  upper  part  is  wide  and  open, 
spread  behind  the  tongue  to  receive  the  masticated 
aliment ; it  begins  from  the  basis  of  the  scull,  near 
the  processus  pterygoides  of  the  sphenoidal  bone, 
then  descending:  becomes  round,  and  is  called  va- 
ginalis  gulae ; it  runs  from  the  tongue  close  to  the 
spine,  under  the  left  subclavian  blood  vessels,  into  and 
through  the  thorax  on  the  left  side,  then  piercing 
the  diaphragm,  it  immediately  enters  the  stomach. 
It  is  composed  of  a thin  outer  coat,  which  is  no 


DUCTUS  ALIMENT  A LIS. 


151 


more  than  a proper  membrane  to  the  middle  or 
muscular  coat.  The  middle  coat  is  composed  of 
longitudinal  and  circular  muscular  fibres,  but  chiefly 
circular,  abundantly  thicker  than  the  same  coat 
in  the  guts ; because  this  has  no  foreign  power  to 
assist  it,  as  the  guts  have,  and  because  it  is  neces- 
sary the  food  should  make  a shorter  stay  here  than 
there.  The  inner  coat  is  a pretty  smooth  mem- 
brane, beset  with  many  glands,  which  secrete  a 
mucilaginous  matter,  to  defend  this  membrane, 
and  render  the  descent  of  the  aliment  easy. 

Ventriculus,  the  stomach,  is  situated  under  the 
left  side  of  the  diaphragm,  its  left  side  touch- 
ing the  spleen,  and  its  right  is  covered  by  the  thin 
edge  of  the  liver  ; its  figure  nearly  resembles  the 
pouch  of  a bagpipe,  its  left  end  being  most  capa- 
cious, the  upper  side  concave,  and  the  lower  con- 
vex : it  has  two  orifices,  both  on  its  upper  part  ; 
the  left,  through  which  the  aliment  passes  into  the 
stomach,  is  named  cardia  ; and  the  right,  through 
which  it  is  conveyed  out  of  the  stomach  into  the 
duodenum,  is  named  pylorus  ; where  there  is  a cir- 
cular valve  which  hinders  a return  of  aliment  out 
of  the  gut,  but  does  not  at  all  times  hinder  the  gall 
from  flowing  into  the  stomach. 

The  coats  of  the  stomach  are  three  ; the  exter- 
nal membranous,  the  middle  muscular,  whose  fi- 
bres are  chiefly  longitudinal  and  circular,  the  in- 
ner membranous,  and  beset  with  glands,  which 
separate  a mucus.  This  last  coat  is  again  divided 


152 


DUCTUS  ALIMENTALIS. 


by  anatomists  into  a fourth,  which  they  call  vrllofa. 
As  the  muscular  coat  of  the  stomach  contracts,  the 
inner  coat  falls  into  folds,  which  increase  as  the  sto- 
mach lessens,  and  consequently  retard  the  aliment 
most  when  the  stomach  is  nearest  being  empty. 

The  manner  in  which  digestion  is  performed 
has  been  matter  of  great  controversy.  The  ancients 
generally  supposed  the  food  concocted  by  a fermen- 
tation in  the  stomach  ; but  the  moderns  more  gen- 
erally attribute  it  to  the  muscular  force  of  the  sto- 
mach; which  Dr.  Pitcairne  has  computed  to 
be  equal  to  a hundred  and  seventeen  thousand  and 
eighty  eight  pounds  weight ; to  which  being  added 
the  absolute  force  of  the  diaphragm  and  abdominal 
muscles  (but  for  what  reason  I am  at  a loss  to  con- 
ceive, when  so  small  a part  of  that  force  can  be  ex- 
erted this  way)  the  sum  then  will  be  more  than 
twice  as  much  ; a force  indeed  equal  to  the  end  for 
which  he  assigns  it.  Now  this  force  of  the  muscu- 
lar coat  of  the  stomach  is  near  forty  times  greater 
than  what  Borelli  has  assigned  to  the  heart, 
which  is  much  stronger ; and  Dr.  Keil  has  under- 
taken to  prove,  that  the  force  which  the  heart  exerts 
is  not  thrice  as  many  ounces  as  Borelli  computes 
it  to  be  thousand  pounds  weight.  Yet  this  is  as 
certain,  as  that  action  and  reaction  are  the  same ; 
that  the  abdominal  muscles  and  the  diaphragm 
compress  the  stomach  with  no  greater  force  than 
they  do  the  liver  and  all  other  parts  contained  in  the 
abdomen ; and  that  the  foetus  in  utero,  and  all  the 


DUCTUS  A LI  MENTAL  IS. 


153 


viscera  in  the  abdomen,  receive  much  more  of  this 
force,  during  the  time  of  gestation  ; and  yet  nei- 
ther the  foetus,  nor  any  other  contained  part,  is  di- 
gested by  that  force  ; and  for  the  force  with  which 
the  stomach  itself  acts,  it  will  be  just  the  same  with 
the  reaction  of  the  food  upon  it,  and  therefore 
should  be  as  much  more  liable  to  be  digested  by 
this  and  the  other  force,  than  the  food,  as  it  oftener 
feels  these  forces  than  that  (only  that  living  bodies 
are  not  so  liable  to  digestion  as  dead  ones  :)  besides, 
it  may  be  demonstrated,  that  the  force  with  which 
the  stomach  compresses  any  part  of  its  contents,  is 
not  greater  than  what  is  given  to  equal  parts  of  the 
contents  in  the  small  guts ; for  if  the  moment  of  a 
muscle  is  as  its  weight,  and  if  the  muscular  coat  of 
the  stomach  does  not  bear  a greater  proportion  to 
the  muscular  coat  of  a small  gut,  than  their  diame- 
ters bear  ; a section  of  the  stomach  having  so  many 
more  equal  parts  to  press  than  a like  section  of  a 
gut,  it  will  require  just  so  much  more  force  to  give 
each  part  the  same  pressure.  Dr.  Drake  has  sup- 
posed, that  digestion  is  performed  in  the  stomach, 
as  in  Papin’s  Digester ; in  which  hypothesis  are 
contained  all  the  absurdities  of  that  of  Pitcairne, 
with  this  addition,  that  the  stomach  must  be  as  ir- 
resistible to  distention  at  that  time,  as  his  iron  pot, 
and  the  orifices  as  forcibly  secured  ; but  then  in- 
deed it  shews  how  bits  of  bones,  which  dogs  swal- 
low, may  be  retained  in  the  stomach  without  tear- 
ing it ; which  difficulty,  in  my  opinion.  Dr.  Pir- 


w 


154 


DUCTUS  ALIMENTALIS. 


cairne  has  not  sufficiently  accounted  for,  though 
it  is  none  of  the  least  in  his  hypothesis.  In  gra- 
nivorous  birds,  where  digestion  is  made  by  muscu- 
lar force,  their  second  stomach  is  plainly  contrived 
for  comminuting  or  digesting  their  food  that  way  ; 
for  besides  that  it  is  one  of  the  strongest  muscles  in 
their  bodies,  its  inside  is  defended  with  a hard  and 
strong  membrane  that  it  may  not  be  torn  j and 
these  birds  always  eat  with  their  grain  the  roughest 
and  hardest  little  stones  they  can  find,  which  are 
necessary  for  grinding  their  food,  notwithstanding 
it  is  first  soaked  in  another  stomach,  and  is  also 
food  of  very  easy  digestion..  In  serpents,  some  birds, 
and  several  kinds  of  fish,  which  swallow  whole 
animals,  and  retain  them  long  in  their  stomachs, 
digestion  seems  to  be  performed  by  a menstruum  •, 
for  we  frequently  find  in  their  stomachs  animals  so 
totally  digested,  before  their  form  is  destroyed,  that 
their  very  bones  are  made  soft.  In  horses  and  oxen, 
digestion  is  but  little  more  than  extracting  a tinc- 
ture ; for  in  their  excrements,  when  voided,  we  see 
the  texture  of  their  food  is  not  totally  destroyed, 
though  grass,  in  particular,  seems  to  be  as  easily  di- 
vided as  any  food  whatever,  and  the  corn  they  eat  is 
often  voided  entire  : and  in  the  excrements  of  men, 
are  often  seen  the  skins  of  fruits  undigested,  and 
small  fruits,  such  as  currants,  unbroke,  and  worms 
also  continue  unhurt,  both  in  the  stomach  and  guts. 
Therefore,  by  comparing  our  stomachs  with  those 
here  mentioned,  it  appears  to  me,  that  our  digestion 


DUCTUS  ALIM  ENT  AXIS. 


155 


is  performed  by  a menstruum,  which  is  chiefly 
saliva,  gently  assisted  by  the  action  of  the  stomach, 
and  the  abdominal  muscles,  and  by  that  principle 
of  corruption  which  is  in  all  dead  bodies.  For  di- 
gestion is  no  other  than  corruption  or  putrefaction 
of  our  food  ; therefore  meats  preserved  from  cor- 
ruption by  salt  or  spirits,  are  hard  of  digestion  and 
unwholesome.  Nevertheless,  when  this  digesting 
menstruum  of  the  stomach  is  too  crude,  the  same 
salts  or  spirits,  moderately  used,  become  a remedy  ; 
and  though  meat  long  salted  is  so  very  unwhole- 
some, it  seems  not  to  be  from  the  salt  itself,  but 
the  meat  made  undigestible  by  being  long  salted:; 
for  those  who  eat  the  greatest  quantity  of  salt  at 
their  meals  are  not  subjected  thereby  to  the  same 
distempers.  And  this  digesting  menstruum,  when 
the  stomach  is  empty,  exciting  that  uneasiness 
which  we  call  hunger,  our  appetites  and  our  di- 
gestion are  thereby  necessarily  suited  both  as  to 
time  and  quantity. 

Duodenum  is  the  first  of  the  three  small  guts  ; 
it  begins  from  the  pylorus  of  the  stomach,  and  is 
thence  reflected  downward  ; it  first  passes  by  the 
gall  bladder,  and  then  under  the  following  gut  and 
mesentery,  and  coming  in  sight  again  in  the  left 
hypochondrium,  it  there  commences  jejunum, 
which  is  the  second  of  the  small  guts  ; but  the 
place  where  this  ends  and  the  other  begins  is  not 
precisely  determined. 


156 


BUCTUS  A LI  MENTAL  IS.' 


Jejunum  is  so  called  from  its  being  found,  for 
the  most  part,  empty  ; it  is  situated  in  the  regio 
umbilicalis,  and  makes  somewhat  more  than  a 
third  part  of  the  small  guts.  It  is  distinguished 
from  the  following  gut  by  its  coats,  which  are  a 
small  matter  thinner  and  less  pale. 

Ileum  is  the  continuation  of  the  former,  situa- 
ted in  the  hypogastrium,  and  very  often  some 
part  of  it  in  the  pelvis  of  the  abdomen,  upon  the 
bladder  of  urine,  especially  in  women  ; it  enters 
the  colon  on  the  right  side,  near  the  upper  edge 
of  the  os  ilium.  This  great  length  of  the  small 
guts  is  evidently  for  the  convenience  of  a greater 
number  of  lacteals,  that  the  chyle  which  misses 
their  orifices  in  one  place  may  not  escape  them  in 
another  ; but  those  animals  which  swallow  their 
food  whole,  and  have  it  a Ion  g time  in  their  stom- 
ach  and  salts,  have  shorter  s;uts  and  fewer  lacteals. 

O J O 

Colon  is  the  first  of  the  great  guts  ; it  begins  at 
the  upper  edge  of  the  right  os  ilium  ; thence 
ascending  passes  under  some  part  of  the  liver,  and 
the  bottom  of  the  stomach,  from  the  right  hypo- 
chondrium  to  the  left,  and  thence  descends  to  the 
pelvis  of  the  abdomen. 

Caecum,  or  append! cula  vermiformis,  is  situ- 
ated on  the  beginning  of  the  colon  : it  is  less  than 
an  earth  worm,  with  a small  orifice  opening  in- 
to the  colon  $ this  gut  has  seldom  any  thing  in 
it.  In  men  it  is  called  one  of  the  large  guts, 
though  it  is  the  smallest  by  far  ; but  the  mistake 


BUCTUS  ALIMENT AL IS. 


157 


arises  from  copying  the  ancients,  whose  descriptions 
of  all  the  parts  contained  in  the  abdomen,  seem  to 
be  taken  from  dogs  ; for  in  them,  and  in  many  other 
animals,  it  is  very  large  : and  some  fish  have  them 
in  great  numbers,  but  very  small  ; I have  counted 
in  a mackerel  above  one  hundred  and  fifty. 

Rectum  is  the  continuation  of  the  colon  through 
the  pelvis  to  the  anus.  The  lower  end  of  this  gut 
is  the  seat  of  the  true  fistula  in  ano,  which  usually 
runs  betwixt  the  muscular  coat  and  the  inner  coat ; 
it  is  cured  by  opening  it  the  whole  length  into 
the  cavity  of  the  gut  ; it  is  yet  better,  if  it  can  be 
done,  to  extirpate  all  that  is  fistulous  and  scirrhous, 
for  that  is  a sure  way  to  make  one  operation  perfect 
the  cure.  The  other  kind  of  fistula,  improperly  so 
called,  is  an  abscess  running  round  the  outside  of 
the  sphincter,  in  the  shape  of  a horse-shoe,  being  a 
circle  all  but  where  this  muscle  unites  with  those 
of  the  penis  ; this  is  best  cured  by  opening  and  re- 
moving part  of  the  outer  skin.  The  first  of  these 
cases  happens  oftenest  in  full  habits,  proceeding  fre- 
quently from  the  piles  ; the  last  is  generally  a criti- 
cal discharge,  and  one  of  nature’s  last  efforts  in  com 
■sumptive  and  scorbutic  habits  of  body.  The  inver- 
sion and  sliding  down  of  this  gut  is  called  prolapsus 
ani,  a disease  common  in  children,  especially  those 
who  are  afflicted  with  the  stone,  and  of  not  much 
consequence  ; in  men  it  is  more  rare  and  more 
dangerous,  being  generally  attended  with  a flux  of 
humours.  This  case  I have  cured  by  taking  away  a 


158 


DUCTUS  ALIM  ENT  A LIS. 


piece  of  the  prolapsed  gut  with  a caustic,  length- 
ways of  the  gut  ; the  wound  discharged  the  flux  of 
humours,  upon  which  the  gut  was  easily  reduced, 
and  cicatrising  in  that  state,  it  never  more  fell  down. 

I have  seen  a case,  where  a bold  unthinking 
surgeon  having  cut  off  the  prolapsed  part,  the  ci- 
catrix was  so  hard  and  contracted  that  the  patient 
could  never  after  go  to  stool  without  a clyster,  and 
then  not  without  great  misery. 

Oftentimes  the  piles  occasion  large  tumours  at 
the  lower  end  of  this  gut ; these  are  always  best 
extirpated  by  ligature ; for  if  they  arc  cut,  they 
will  sometimes  bleed  excessively,  and  it  is  no  easy 
matter  to  apply  any  thing  to  stop  a flux  of  blood 
in  that  part. 

The  guts  have  the  same  coats  with  the  stomach  j 
the  fibres  of  their  middle  or  muscular  coat  are  cir- 
cular, or  spiral,  and  longitudinal ; of  the  latter  but 
very  few.  The  antagonists  to  these  muscular  fibres 
of  the  stomach  and  guts,  are  their  contents  pressed 
from  one  place  to  another,  and  the  muscles  of  the 
abdomen,  for  these  pressing  upon  them  alter  their 
form  into  one  less  capacious  ; which  necessarily 
extends  their  circular  fibres.  The  great  guts  have 
three  membranes,  or  ligaments,  on  the  outside,  run- 
ning their  whole  length,  and  supporting  the  sacculi, 
into  which  those  guts  are  divided.  The  lesser  guts 
have,  at  very  small  distances,  semilunar  valves  placed 
opposite  to  the  interstices  of  each  other,  to  prevent 
the  aliment  from  passing  too  speedily  through  the 


DUCTUS  ALIMENTALIS. 


159 


guts  ; and  the  better  to  answer  that  end,  they  are 
larger  and  more  numerous  near  the  stomach,  where 
the  food  is  thinner,  than  they  are  towards  the  colon, 
where  the  food  is  continually  made  thicker  in  its 
progress,  by  a discharge  of  part  of  the  chyle.  This 
contrivance,  so  necessary  to  men,  because  of  their 
erect  posture,  when  they  are  obliged,  by  sickness 
or  accidents,  to  lie  along,  becomes  a great  inconve- 
nience, and  calls  for  the  help  of  clysters  and  purges. 
But  brutes  have  not  these  valves,  because  they  are 
not  convenient  in  an  horizontal  posture.  At  the 
entrance  of  the  ileum  into  the  colon,  are  two  very 
large  valves,  which  effectually  hinder  the  regress  of 
the  foeces  into  the  ileum.  But  clysters  have  been 
frequently  known  to  pass  them,  and  be  vomited 
up  ; though  the  excrement  that  is  sometimes  vomit- 

Ied  up,  I am  inclined  to  think,  is  such  as  had  not 
passed  into  the  great  guts.  The  other  valves  in  the 
colon  are  placed  opposite,  but  not  in  the  same 
plane,  to  each  other,  and  make,  with  their  ante- 

[rior  edges,  an  equilateral  triangle ; but  as  the  gut 
approaches  the  anus,  they  become  less  remarkable, 
and  fewer  in  number. 

All  the  guts  have  in  their  inner  membrane  an 
almost  infinite  number  of  very  small  glands  : these 
glands  will,  especially  some  of  them  in  the  large 
guts,  appear  to  the  naked  eye  when  they  are  dis- 
eased : they  are  called  glandulse  pyeriance. 

The  length  of  the  guts  to  that  of  the  body  is 
as  five  to  one  in  a middle  sized  man  ; in  taller  men 


160 


MESENTERY. 


the  proportion  is  usually  less,  and  in  short  men 
greater. 

Mesentery  is  a membrane  beginning  loosely  up- 
on the  loins,  and  is  thence  produced  to  all  the  guts  : 
it  preserves  the  jejunum  and  ileum  from  twisting 
in  their  peristaltic  or  vermicular  motion,  and  con- 
fines the  rest  to  their  places.  It  sustains  all  the 
vessels  going  to  and  from  the  guts,  viz.  arteries, 
veins,  lymphxducts,  lacteals  and  nerves,  and  also 
contains  many  glands,  called,  from  their  situation, 
mescntericx.  The  beginning  of  this  membrane' 
from  the  loins,  is  about  three  or  four  inches  broad, 
but  next  the  guts  of  the  same  length  with  the  side 
of  the  guts  they  adhere  to,  which  is  in  the  small  guts, 
about  a fourth  part  shorter  than  the  other  side  ; but 
when  this  membrane  is  separated  from  the  small 
guts,  it  shrinks,  and  measures  about  two  thirds  less. 

I opened  a boy,  about  twelve  years  old,  that  di- 
ed of  the  iliac  passion,  vulgarly  called  the  twisting 
of  the  guts ; the  guts,  stomach,  duodenum,  and 
jejunum  were  distended,  with  vapour  and  air,  to 
near  ten  times  their  natural  capacity,  which  so  com- 
pressed the  intestinum  ileum,  that  nothing  could 
pass  through  it.  The  relations  of  this  boy  could 
give  no  other  account  of  the  cause  of  this  disease, 
than  that  of  his  having  eaten  a large  quantity  of 
raw  your.g  carrots.  This  case  happens  very  fre- 
quently to  lambs  that  have  been  housed,  and  turned 
out  early  in  the  spring  to  grass,  when  the  grass  is 
very  rank  and  succulent ; and  also  to  horses,  oxen. 


LIVER. 


161 


and  sheep,  when  they  happen  to  feed,  by  any  ao 
cident,  upon  young  beans  or  peas,  or  rich  clover 
grass,  which  are  very  apt  to  ferment  in  their  stom- 
achs. In  these  animals  this  case  is  commonly  cur- 
ed by  running  a knife  into  their  guts  ; some  in- 
stances of  which  I have  seen,  and  have  heard  a 
great  many  reported  ; but  this  case  happening  very 
rarely  to  men,  I believe  that  practice  has  never  yet 
been  used  ; though  the  instrument  which  is  used 
for  tapping  in  a dropsy  of  the  abdomen,  might  do 
it  with  great  ease  and  safety.  Some  anatomists, 
who  have  considered  the  impossibility  of  a twisting 
of  the  guts,  which  is  the  vulgar  name  of  this  dis- 
ease, have  imagined  that  it  proceeded  from  one 
gut  being  involved  in  another.  These  involutions 
are  found  frequently  in  bodies  that  die  a natural 
death,  and  without  any  inflammation,  or  any  other 
symptom  of  pain. 


CHAPTER  V. 

Of  the  liver,  gall-bladder,  pancreas  an© 

SPLEEN. 

The  liver  is  the  largest  gland  in  the  body  • of  a 
dusky  red  colour.  It  is  situated  immediately  un- 
der the  diaphragm  in  the  right  hypochondrium  ; 
its  exterior  side  is  convex,  and  interior  concave  ; 
backward  toward  the  ribs  it  is  thick,  and  thin 
on  its  fore  part,  where  it  covers  the  upper  side 


x 


162 


LIVER/ 


of  the  stomach,  and  some  of  the  guts ; the  upper 
side  of  it  adheres  to  the  diaphragm,  and  is  also  tied 
to  it  and  the  sternum  by  a thin  ligament,  which  is 
described  commonly  as  two  ; the  upper  part  called 
suspensorium,  and  the  anterior  latum : but  either 
of  these  names  is  sufficient  for  it  all.  It  is  also  tied 
to  the  navel  by  a round  ligament  called  teres  or 
umbilicale,  which  is  the  umbilical  vein  degenerated 
into  a ligament  ; it  is  inserted  into  the  liver  at  a 
small  fissure  in  its  lower  edge.  The  ligamentum 
latum,  or  suspensorium,  sustains  the  liver  in  an 
erect  posture,  or  rather  fixes  it  in  its  situation,  while 
it  is  supported  by  the  other  viscera,  they  being  com- 
pressed by  the  abdominal  muscles ; in  lying  down 
the  teres  prevents  it  from  pressing  on  the  dia- 
phragm ; and  in  lying  on  the  back,  they  both  to- 
gether suspend  it,  that  it  may  not  compress  and  ob- 
struct the  ascending  vena  cava.  It  is  nourished  by 
the  branches  of  the  celiac  and  mesenteric  arteries  in 
the  liver,  called  arterix  hepaticx,  but  its  blood  ves- 
sels, that  compose  it  as  a gland,  are  the  branches  of 
the  vena  portae,  which  enters  the  liver,  and  distrib- 
utes its  blood  like  an  artery,  to  have  the  bile  secreted 
from  it  j and  the  branches  of  the  cava  in  the  liver, 
which  return  the  redundant  blood  into  the  cava  as- 
cendens  : it  has  also  several  branches  of  nerves,  and 
a great  number  of  lymphatics  ; of  which  I shall  treat 
in  their  respective  places.  Dogs  and  cats,  and  other 
animals,  that  have  a great  deal  of  motion  in  their 
backs,  have  their  livers  divided  into  many  distinct 


©ALL-BLADDER. 


163 


iobules  ; which,  by  moving  one  against  another, 
comply  with  those  motions,  which  else  would  break 
their  livers  to  pieces. 

The  gall-bladder  is  a receptacle  of  bile,  seated 
in  the  hollow  side  of  the  liver ; it  is  composed  of 
one  dense  coat  somewhat  muscular,  which  is  cov- 
ered with  a membrane  like  that  of  the  liver  ; and 
is  also  lined  with  another,  that  cannot  easily  be  sep- 

Iarated.  Modern  anatomists  have  described  a num- 
ber of  small  ducts  leading  from  the  liver  to  the  gall- 
bladder, by  which  they  suppose  the  gall-bladder  is 

filled : and  these  I thought  I had  seen  in  a human 

. ° 

body  that  died  of  a jaundice,  when  I was  a very 
young  anatomist ; but  never  being  able  to  see  any 
since  in  any  animal,  though  I have  made  very  dili- 
gent inquiry  by  experiments  and  dissection,  I am 
now  persuaded  that  there  are  no  such  ducts  ; for  if 
they  are  too  little  to  be  seen  or  filled  by  injections, 
I think  they  are  too  little  for  the  end  for  which 
they  are  assigned.  As  to  the  argument  for  the  ex- 
istence of  such  ducts,  which  is  fetched  from  the 
difficulty  of  the  gall-bladder’s  being  filled  through 
the  ductus  cysticus  from  the  ductus  hepaticus,  I 
think  it  is  of  little  weight,  seeing  the  vesicuke  semi- 
nales  are  filled  with  a thicker  fluid  through  a less  di- 
rect  passage.  From  the  gall-bladder  towards  the  du- 
odenum runs  a duct  called  cysticus  ; and  from  the 
liver  to  this  duct  one  called  hepaticus,  which  car- 
ries off  the  gall  this  way,  when  the  gall-bladder 
is  full  ; then  the  ductus  cysticus  and  hepaticus 


164 


GALL-BLADDER. 


being  united,  commence  ductus  communis  chole- 
dochus,  which  enters  the  duodenum  obliquely 
about  four  inches  below  its  beginning.  The  ori- 
fice of  this  duct  in  the  gut  is  somewhat  eminent, 
but  has  no  caruncle,  as  is  commonly  said.  As 
the  liver  from  its  situation  in  the  same  cavity  with 
the  stomach,  will  be  most  pressed,  and  consequent- 
ly separate  most  gall  when  the  stomach  is  fullest, 
which  is  the  time  when  it  is  most  wanted  ; so  the 
gall-bladder,  being  seated  against  the  duodenum, 
it  will  have  its  fluid  pressed  out  by  the  aliment 
passing  through  that  gut,  and  consequently  at  a 
right  time  and  in  due  proportion ; because  the 
greater  that  quantity  of  aliment  is,  the  greater  will 
be  the  compression  ; and  so  the  contrary. 

I know  no  way  of  computing,  with  any  exact- 
ness, the  quantity  of  bile  that  is  usually  secreted  by 
the  liver  in  a given  time  ; but  if  it  is  four  times  as 
much  as  all  the  salivary  glands  secrete,  it  may  be 
twenty  four  ounces  for  every  meal  : to  which  be- 
ing added  six  ounces  of  saliva,  which,  from  what 
is  observed  in  the  chapter  of  the  salivary  glands,  I 
think  will  appear  a moderate  computation  : and 
supposing  the  pancreas  in  the  same  time  secretes 
three  ounces,  there  will  then  be  thirty  three 
ounces  of  fluids  separated  for  the  digestion  of  one 
meal ; and  that  these  necessary  fluids  may  not  be 
wasted  in  such  quantities,  they  pass  into  the  blood 
with  the  chyle,  and  may  be  soon  separated  again  for 
the  same  use  ; and  very  likely,  some  of  the  same  bile 


PANCREAS. 


165 


may  be  employed  more  than  once,  for  digesting  part 
of  the  same  meal ; and  as  the  liver  exceeds  all  the 
glands  in  the  body  in  magnitude,  and  its  excreto- 
ry ducts  ending  in  the  duodenum,  it  seems  to  me 
to  be  much  more  capable  of  making  those  large 
separations  from  the  blood,  which  are  procured  by 
cathartics,  than  the  scarce  visible  glands  of  the  guts. 
The  liver  ordinarily  weighs,  in  a middle  sized  man, 
about  three  pounds  twelve  ounces,  the  pancreas 
three  ounces,  and  the  spleen  fourteen  ounces.  I 
have  seen  a diseased  liver  in  a man  that  weighed 
fourteen  pounds  four  ounces : and  in  a boy  but  nine 
years  old,  that  died  hydropic,  the  liver  full  of  hy- 
datids, and  cysts  of  hydatids  adhering  to  it,  which 
together  weighed  seven  pounds  one  ounce  and  a 
half,  though  several  pints  of  water  had  been  let  out 
of  it  before.  The  spleen  in  the  same  boy,  together 
with  the  hydatids  contained  in  its  membrane, 
weighed  three  pounds.  In  a man  I found  a diseased 
spleen,  weighing  five  pounds  two  ounces  ; and  in 
an  old  man,  six  feet  high,  I found  a sound  liver 
weighing  no  more  than  twenty  eight  ounces,  and 
the  spleen  but  ten  ounces : and  in  a man  that  had 
been  cured  of  a dropsy  I found  a polypus  very  solid, 
almost  filling  the  large  branches  of  the  porta  in  the 
liver,  and  a stone  between  the  liver  and  gall-blad- 
der, larger  than  a nutmeg. 

Pancreas,  the  sweet  bread,  is  a large  gland 
of  the  salivary  kind,  lying  across  the  upper  and 
back  part  of  the  abdomen,  near  the  duodenum  ; it 


166 


PANCREAS. 


has  a short  excretory  duct,  about  half  as  large  as  a 
crow  quill,  though  it  is  commonly  painted  as  large 
as  the  ductus  communis  choledochus  : it  always  en- 
ters the  duodenum  together  with  the  bile  duct ; but 
in  dogs  some  distance  from  it  ; and,  I think,  al- 
ways in  two  ducts  distant  from  one  another.  The 
juice  of  this  gland,  together  with  the  bile,  helps  to 
complete  the  digestion  of  the  aliment,  and  renders 
it  fit  to  enter  the  lacteal  vessels.  In  a man  that  died 
of  a jaundice,  I found  the  ductus  communis  chole- 
dochus constricted  by  a scirrhous  pancreas,  the 
gall-bladder  extended  to  the  size  of  a goose  egg, 
and  all  the  ducts  to  twice  their  natural  bigness. 
This  is  the  case  in  which  I thought  I had  so  plainly 
seen  the  cystihepatic  ducts  : I once  saw  the  ductus 
cysticus  obstructed,  without  the  gall-bladder  be- 
ing distended,  which,  l think,  furnishes  us  with 
a very  probable  argument  against  the  existence  of 
cystihepatic  ducts.  In  those  who  die  of  the  jaun- 
dice, for  the  most  part  are  found  in  the  gall-bladder 
and  the  biliary  ducts  concretions  of  bile  so  light  as 
to  swim  in  water,  yet  are  called  gall  stones  : these 
cause  the  jaundice,  by  obstructing  the  ducts  : many 
of  those  who  have  been  cured  of  this  disease,  have 
had  great  numbers  of  these  stones  found  in  their  ex- 
crements. A patient  of  mine,  who  had  voided  by 
stool  several  of  these  stones,  had  afterwards  two  of 
half  an  inch  diameter,  which  made  their  way 
through  the  integuments  of  the  abdomen,  and  was 
cured  without  much  pain.  Oxen,  as  the  same  gen- 


SPLEEN. 


167 


tleman  informed  me,  who  have  been  long  fed  upon 
rymeat,  abound  with  them  ; while  others,  fed  with 
them,  and  afterwards  turned  to  grass,  when  killed, 
are  found  without  them.  This  gentleman  could 
never  eat  any  herbs.  He  also  informed  me  of  a 
physician  in  France,  that  with  great  reputation 
cured  the  jaundice  by  giving  his  patients  large 
quantities  of  the  juice  of  herbs. 

The  spleen  is  seated  in  the  left  hypochondrium, 
immediately  under  the  diaphragm,  and  above  the 
kidney,  between  the  stomach  and  the  ribs  ; it  is 
supported  by  the  subcontained  parts,  and  fixed  to 
its  place  by  an  adhesion  to  the  peritonaeum  and  dia- 
phragm ; it  is  also  connected  to  the  omentum,  as 
has  been  observed.  The  figure  of  it  is  a sort  of  de- 
pressed oval,  near  twice  as  long  as  broad,  and  almost 
twice  as  broad  as  thick.  Sometimes  it  is  divided  into 
lobules,  but  for  the  most  part  has  only  one  or  two 
small  fissures  on  its  edge,  and  sometimes  none  ; in 
its  colour  it  resembles  cast  iron.  The  inner  texture, 
in  brutes,  is  vesicular,  like  the  penis ; in  which 
vesicles  are  found  grumous  blood,  and  small  bodies 
like  glands  : but  Ruysch  denies  that  the  human 
spleen  is  of  the  same  texture.  The  spleen  I have 
seen  taken  out  of  a dog,  without  any  remarkable 
inconvenience  to  him.  I have  twice,  in  a human 
body,  seen  three  spleens,  twice  two,  and  once  four  ; 
some  of  these  were  very  small,  others  nearly  equal, 
but  altogether  in  any  of  these  bodies  were  not 
larger  than  the  one  which  is  usually  found. 


VASA  LACTEA. 


168 


CHAPTER  VJ. 


OF  THE  VASA  EACTEA. 


Vasa  lactea  are  the  venae  lactese,  receptaculum 
chyli,  and  ductus  thoracicus. 

Venae  lacteae,  &c.  are  a Vast  number  of  very 
line  pellucid  tubes,  beginning  from  the  small  guts, 
and  proceeding  thence  through  the  mesentery  ; 
they  frequently  unite,  and  form  fewer  and  larger 
vessels,  which  first  pass  through  the  mesenteric 
glands,  and  then  into  the  receptaculum  chyli.  These 
vessels,  ere  they  arrive  at  the  mesenteric  glands,  or 
in  dogs  the  pancreas  asellii,  which  is  these  glands 
collected,  are  called  venae  lacteae  primi  generis  ; and 
thence  to  their  entrance  into  the  receptaculum  chy- 
li, venae  lacteae  secundi  generis.  The  office  of  these 
veins  is  to  receive  the  fluid  part  of  the  digested  ali- 
ment, which  is  called  chyle,  and  convey  it  to  the 
receptaculum  chyli,  that  it  may  be  thence  carried 
through  the  ductus  thoracicus  into  the  blood  vessels. 

For  the  following  excellent  description,  thus 
marked  “ , of  the  receptaculum  chyli,  and  ductus 
thoracicus,  I am  obliged  to  Mr.  Monro. 

“ Receptaculum  chyli  pecqueti,  or  saccus  lac- 
“ teus  van  home,  is  a membranous  somewhat 
u pyriform  bag,  two  thirds  of  an  inch  long, 
“ one  third  of  an  inch  over  in  its  largest  part, 
“ when  collapsed  ; situated  on  the  first  vertebra 
st  lumbrorum,  to  the  right  of  the  aorta,  a little  higher 


VASA  LACTEA. 


169 


« than  the  arteria  emulgens  dextra,  under  the  right 
“ inferior  muscle  of  the  diaphragm.  It  is  formed 
“ by  the  union  of  three  tubes  ; one  from  under 
44  the  aorta,  the  second  from  the  interstice  of  the 
44  aorta  and  cava,  the  third  from  under  the  emulgents 
44  of  the  right  side.  The  saccus  chyliferus  at  its 
44  superior  part  becoming  gradually  smaller,  is  con- 
44  tracted  into  a slender  membranous  pipe  of  about 
44  a line  diameter,  well  known  by  the  name  of 
44  Ductus  thoracicus.  This  passes  betwixt  the 
44  appendices  musculoss  diaphragmatis,  on  the 
“ right  of,  and  somewhat  behind  the  aorta,  then 
“ lodged  in  the  cellular  substance  under  the  pleu- 
44  ra  ; it  mounts  between  this  artery  and  vena  sine 
“ pari,  or  azygos,  as  far  as  the  fifth  vertebra 
“ thoracis,  where  it  is  hid  by  the  azygos,  as  this 
“ vein  rises  forward  to  join  the  cava  descendens ; 
“ after  which  the  duct  passes  obliquely  over  to  the 
44  left  side  under  the  oesophagus,  aorta,  descendens, 
44  and  great  curvature  of  the  aorta,  until  it  reaches 
44  the  left  carotid,  stretching  farther  towards  the 
44  left  internal  jugular,  by  a circular  turn,  whose 
44  coir^ex  part  is  uppermost : at  the  top  of  this  arch 
44  it  splits  into  two  for  one  half  line,  the  superior 
44  branch  receiving  into  it  a large  lymphatic  from 
44  the  cervical  glands.  This  lymphatic  appears,  by 
44  blowing  and  injections,  to  have  two  valves ; 
44  when  the  two  branches  are  united,  the  duct  con- 
44  tinues  its  course  to  the  internal  jugular,  behind 
44  which  it  descends,  and  immediately  at  the  left 

Y 


170 


VASA  LACTEA. 

“ side  of  the  insertion  of  this  vein,  enters  the  su= 
t£  perior  and  posterior  part  of  the  left  subclavian, 
whose  internal  membrane  duplicated  forms  a se~ 
4C  milunar  externally  convex  valve  that  covers  two 
“ thirds  of  the  orifice  of  the  duct.  Immediately 
“ below  this  orifice  a cervical  vein  from  the  mus- 
“ culi  scaleni  enters  the  subclavian.  The  thin  coat 
<c  and  valves,  commonly  ten  or  twelve,  of  this  duct, 
“ are  so  generally  known,  I need  not  mention  them. 
“In  my  notes  I find  little  variation  in  the  recep- 
“ taculum,  only  its  different  capacities  in  different 
“ subjects,  and'  sometimes  more  ducts  concurring 
“ in  the  formation  of  it.  The  diameter  of  the  duct 
“ varies  in  most  bodies,  and  in  the  same  subject  is 
u uniform,  but  frequently  sudden  enlargements  or 
“ sacculi  of  it  are  observable.  The  divisions  which 
“ authors  mention  of  this  duct  within  the  thorax 
“ are  very  uncertain.  In  a woman  I dissected  last 
“ summer,  at  the  eighth  vertebra  thoracis,  one 
f ' branch  climbed  over  the  aorta,  and  about  the 
“ fifth  vertebra  slipped  back  again  under  that  artery 
“ to  the  other  branch,  which  continued  in  the  or- 
u dinary  course.  Last  winter  I found  this  duct  of 
“ a man  discharging  itself  entirely  into  the  right 
u subclavian  vein.  The  precise  vertebra,  where  it 
“ begins  to  turn  towards  the  left,  is  also  uncertain. 
“ Frequently  it  does  not  split  at  its  superior  arch  ; 
“ in  which  case  a large  saccus  is  found  near  its  aper- 
turc  into  the  subclavian  vein.  Generally  it  has 
but  one  orifice,  though^  I have  seen  two  in  one: 


VASA  LA6TEA. 


271 


« 

^ body,  and  three  in  another;  nay,  sometimes  it 
£C  divides  into  two  under  the  curvature  of  the  great 
<c  artery  ; one  goes  to  the  right,  another  to  the  left 
■“  subclavian  ; this  however  is  very  rare.  The  lym- 
44  phatic,  which  enters  the  superior  arch,  is  often 
64  sent  from  the  thyroid  gland.” 

Supposing  there  ordinarily  passes  five  pounds 
of  chyle  in  a day  through  the  lacteals,  and  that 
four  ounces  of  this  only  are  added  to  the  blood 
(though  it  may  be  any  other  quantity,  for  aught  I 
know)  and  that  a man  neither  decreases  or  increas- 
es during  this  time,  then  all  the  separations  from 
the  fluids  and  solids  must  be  just  five  pounds  ; four 
ounces  of  which  must  be  those  fluids  and  particles 
of  solids,  which  are  become  unprofitable  ; and  the 
remaining  four  pounds  twelve  ounces  will  serve  as  a 
vehicle  to  carry  the  four  ounces  off : so  that  we  see 
for  what  reason  more  fluids  are  carried  into  the 
blood  than  are  to  be  retained  there,  and  how  the 
•body  is  by  the  same  means  both  nourished  and  pre- 
served in  health. 


172 


PLEURA,  MEDIASTINUM1, 

O 


CHAPTER  VII. 


OF  THE  PLEURA,  MEDIASTINUM,  LUNGS,  PERICAR- 
DIUM, AND  HEART. 

Pleura  is  a fine  membrane  which  lines  the 
whole  cavity  of  the  thorax,  -except  on  the  dia- 
phragm, which  is  covered  with  no  other  than 
its  own  proper  membrane.  The  back  part  of  it 
is  extended  over  the  great  vessels,  like  the  perito- 
naeum ; and  in  regard  this  membrane  passes  partly 
under  these  vessels,  as  the  peritonaeum  does  in  the 
abdomen,  they  may  be  said  to  lie  in  a duplicature 
of  it ; it  serves  to  make  the  inside  of  the  thorax 
smooth  and  equal. 

Mediastinum  divides  the  thorax  lengthways, 
from  the  sternum  to  the  pericardium  and  pleura, 
which  is  a very  short  space,  but  in  many  brutes 
very  considerable.  It  divides  into  two  in  men,  but 
in  brutes  it  is  single  ; it  divides  the  thorax  not  ex- 
actly in  the  middle,  but  towards  the  left  side,  and 
is  so  disposed,  that  the  two  cavities,  into  which  it 
divides  the  thorax,  do  not  end  toward  this  mem- 
brane in  an  angle,  but  a segment  of  a circle  ; it 
hinders  one  lobe  of  the  lungs  from  incommoding 
the  other,  as  in  lying  on  one  side  the  uppermost 
might  do  ; and  prevents  the  disorders  of  one  lobe  of 
the  lungs  from  affecting  the  other. 

The  lungs  are  composed  of  two  lobes,  one  seated 
on  each  side  of  the  mediastinum  ; each  of  which 


AND  LUNGS, 


173 


lobes  are  subdivided  into  two  or  three  lobules, 
which  are  most  distinctly  divided  in  such  animals 
as  have  most  motion  in  their  backs,  for  the  same  end 
that  the  liver  is  in  the  same  animals.  They  are  each 
composed  of  very  small  cells,  which  are  the  ex- 
tremities of  the  aspera  arteria  or  bronchos.  The 
figure  of  these  cells  is  irregular ; yet  they  are  fitted 
to  each  other  so  as  to  have  common  sides,  and  leave 
no  void  space.  Into  these  cells  the  blood  vessels  dis- 
charge a large  quantity  of  lymph,  or  materia  per- 
spirabilis,  which  at  once  keeps  them  from  being  dri- 
ed by  the  air,  and  makes  a large  and  necessary  dis- 
charge from  the  blood,  as  has  already  been  observed 
upon  the  subject  of  perspiration  through  the  skin. 
Dr.  Willis  has  given  a very  particular  description 
of  the  inner  texture  of  the  lungs,  but  it  is  only  im- 
aginary and  false,  as  he,  and  they  who  have  copied 
his  cuts  and  descriptions,  could  not  but  have  known. 
If  they  had  ever  made  the  least  inquiry  into  the  lungs 
of  any  animal ; nor  is  his  account  of  the  lymphat- 
ics on  the  surface  of  the  lungs,  at  all  more  true 
than  that  of  their  texture.  In  the  membranes 
of  these  cells  are  distributed  the  branches  of  the 
pulmonary  artery  and  vein.  The  known  uses  of 
the  air’s  entering  the  lungs,  are  to  be  instrumental 
in  speech,  and  to  convey  effluvia  into  the  nose,  as 
it.  passes  for  the  sense  of  smelling  ; but  the  great 
use  of  it,  by  which  life  is  preserved,  I think  we 
do  not  understand.  By  some  the  force  of  the  air  is 
thought  to  separate  the  globuli  of  the  blood  that 


•174 


•LUNGS. 


have  cohered  in  the  slow  circulation  through  the 
veins  ; and  this  opinion  seems  to  be  favoured  by 
the  many  instances  of  polypuses,  which  are  large 
concretions  of  the  globuli  of  the  blood,  found  in 
the  veins  near  the  heart,  and  in  the  right  auricle 
and  ventricle  of  the  heart ; and  their  being  so  seldom 
found  in  the  pulmonary  veins,  or  in  the  left  auricle 
or  ventricle  of  the  heart,  or  in  any  of  the  arteries  j 
but  if  it  is  true  that,  while  the  blood  passes  through 
the  lungs,  many  cohering  globuli  are  separated,  yet 
it  remains  to  be  proved  that  these  separations  are 
made  by  the  force  of  the  air.  Dr.  Keil  has  com- 
puted the  force  of  the  air  in  the  strongest  exspira- 
tions  against  the  sides  of  all  the  vesicles,  to  be  equal 
to  fifty  thousand  pound  weight  j which  though  wre 
should  grant,  we  shall  still  find  the  moment  of  the 
air  in  the  lungs  exceeding  small  in  any  small  space. 
For  the  velocity  with  which  the  air  moves  in  the 
lungs  is  as  much  less  than  that  with  which  it  moves 
in  the  windpipe,  as  the  square  of  a section  of  the 
cells  in  the  lungs  is  greater  than  the  square  of  a sec- 
tion of  the  windpipe ; and  therefore  if  the  square 
of  all  the  extreme  blood  vessels  in  the  lungs  do  not 
bear  a greater  proportion  to  the  square  of  the  large 
pulmonary  vessels  than  the  square  of  the  cells  do 
to  the  windpipe,  and  if  the  blood  in  these  large  ves- 
sels moves  as  fast  as  the  air  in  the  windpipe,  then  the 
blood  moving  in  the  smallest  vessels  of  the  lungs 
with  a velocity  equal  to  that  of  the  air  in  the  cells, 
the  blood  will  have  as  much  more  attrition  froiyj 


LUNGS. 


17. 


the  power  that  moves  it  in  its  own  vessels,  than  the 
xir  can  give  upon  them,  as  blood  is  heavier  than 
air.  Besides,  air  pressing  equally  to  all  sides,  and 
the  globuli  of  the  blood  swimming  in  a fluid  ; this: 
pressure,  be  it  what  it  will,  I think,  can  be  of  lit- 
tle use  to  make  such  separations.  Indeed  it  may 
be  objected  that  the  greatest  pressure  is  in  exspira- 
tion,  yet  that  surely  cannot  be  very  great,  while 

Ithe  air  has  so  free  a passage  out  of  them.  Others 
have  thought,  that  the  air  enters  the  blood  vessels 
from  the  cells  in  the  lungs,  and  mixes  with  the 
blood ; but  this  opinion,  however  probable,  wants 
sufficient  experiments  to  prove  it  ; air  being  found 
in  the  blood,  as  it  certainly  is,  is  no  proof  of  its 
entering  this  way,  because  it  may  enter  with  the 
chyle : nor  is  the  impossibility  which  has  been 
urged  of  its  entering  at  the  lungs  without  the  blood 
being  liable  to  come  out  the  same  way  into  the  ve- 
: sides  of  the  lungs,  a good  argument  to  the  contra- 
ry ; for  if  a pliable  duct  passes  between  the  mem- 
branes of  a vessel,  through  a space  greater  than 
the  square  of  its  orifice,  no  fluid  can  return,  because 
the  pressure  which  should  force  it  back  will  be 
greater  against  the  sides  of  that  duct  than  its  orifice  ; 
which  is  the  case  of  the  bile-duct  entering  the  duo- 
denum, arid  the  ureters  entering  the  bladder.  I 
think  the  most  probable  argument  for  the  air’s  en- 
tering into  the  blood  by  the  lungs,  or  rather  some 
particular  part  of  the  air,  may  be  fetched  from  a / 
known  experiment  of  each  man  in  a diving  bell 


LUxtiS. 


176 

wanting  near  a gallon  of  fresh  air  in  a minute  ; and 
if  pressure  only  was  wanted  in  this  case,  they  often 
.descend,  till  the  pressure  of  the  air  is  three  or  four 
times  what  it  is  upon  the  surface  of  the  earth,  with-* 
out  any  advantage  from  that  pressure  ; and  animals 
dying  so  soon  in  air  that  has  been  burnt,  and  their 
being  so  easily  intoxicated  by  breathing  air  much 
impregnated  with  spirituous  liquors,  are  also  argu- 
ments of  a passage  this  way  into  the  blood.  Besides, 
if  pressure  of  the  air  in  the  cells  of  the  lungs  is  the 
only  use  of  it,  I do  not  see  but  enough  of  that  may 
be  had  while  a man  is  hanging,  if  tno  muscles  of 
the  thorax  do  but  act  upon  the  air  which  was 
left  in  the  thorax  when  tiie  rope  was  first  fixed,, 
and  yet  death  is  brought  about  by  hanging  no  other 
way  than  by  interrupting  of  the  breath,  as  I have 
found  by  certain  experiments.  Dr.  Drake  has 
endeavoured  to  shew,  that  the  use  of  respiration  is 
to  assist  the  systole  of  the  heart  ; but  this  use  re- 
quires that  the  systole  and  diastole  of  the  heart 
should  keep  time  with  exspiration  and  inspiration, 
which  is  contrary  to  experience.  The  lungs  of  an- 
imals, before  they  have  been  dilated  with  air,  are 
specifically  heavier  than  water  ; but  upon  inflation 
they  become  specifically  lighter,  and  swim  in  wa- 
ter ; which  experiment  may  be  made  to  discover 
whether  a dead  child  was  still  born,  or  not  ; but  if 
the  child  has  breathed  but  a little,  and  the  experi- 
ment is  made  long  after,  the  lungs  may  be  collapsed 
and  grow  heavier  than  water,  as  I have  experiment- 


PERICARDIUM  AND  HEART.  177 

ed,  which  may  sometimes  lead  a man  to  give  a 
wrong  judgment  in  a court  of  judicature,  but  then 
it  will  be  on  the  charitable  side  of  the  question. 
Adhesions  of  the  lungs  to  the  pleura  are  in  men  so 
common,  that  I know  not  how  to  call  it  a disease  5 
they  being  found  so  more  or  less  in  most  adult 
persons,  and  without  any  inconvenience,  if  the 
lungs  are  not  rotten. 

Pericardium,  or  heart  purse,  is  an  exceeding 
strong  membrane  which  covers  the  heart  ; its 
side  next  the  great  vessels  is  partly  connected  to 
them,  and  partly  to  the  basis  of  the  heart,  but, 
I think,  not  properly  perforated  by  those  vessels  5 
and  its  lower  side  is  inseparable  from  the  tendinous 
part  of  the  diaphragm,  but  not  so  in  brutes,  in 
some  of  which  there  is  a membranous  bag  between 
it  and  the  diaphragm,  which  contains  a lobule  of 
the  lungs.  It  encloses  all  the  heart  to  its  basis  ; 
its  uses  are  to  keep  the  heart  in  its  place,  without 
interrupting  its  office,  to  keep  it  from  having  any 
friction  with  the  lungs,  and  to  contain  a liquor 
to  lubricate  the  surface  of  the  heart,  and  abate  its 
friction  against  the  pericardium. 

The  heart  is  a muscle  of  a conic  figure,  with 
two  cavities  or  ventricles  5 its  basis  is  fixed  by  the 
vessels  going  to  and  from  it,  upon  the  fourth  and 
fifth  vertebrae  of  the  thorax ; its  apex,  or  point, 
is  inclined  downward  and  to  the  left  side,  where- 
it  is  received  in  a cavity  of  the  left  lobe  of  the 
lungs,  as  may  be  observed,  the  lungs  being  extended 


178  • - HEART. 

with  air.  This  incumbrance  on  the  left  lobe  of  the 
lungs,  1 imagine,  is  the  cause  of  that  side’s  being 
most  subject  to  those  pains  which  are  usually  called 
pleuritic,  which  I have  ever  found  upon  dissecting 
of  them  to  be  inflammations  in  the  lungs. 

At  the  basis  of  the  heart,  on  each  side,  are  situ- 
ated the  two  auricles  to  receive  the  blood  the  right 
from  the  two  venae  cavae,  and  the  left  from  the  pul- 
monary Veins  ; in  the  right,  at  the  meeting  of  the 
cavae,  is  an  eminence  called  tuberculum  Loweri* 
which  directs  the  blood  into  the  auricle  ; immedi- 
ately below  this  tubercle,  in  the  ending  of  the  cava 
ascendens,  is  the  vestigium  of  the  foramen  ovale 
(vid.  chap.  Of  the  foetus  ;)  and  near  this,  in  the 
auricle,  is  the  mouth  of  the  coronary  veins.  Both 
auricles  are  strengthened  by  muscular  columnae,  like 
the  ventricles.  The  left  is  much  less  than  the  right ; 
but  the  difference  is  supplied  by  a large  muscular 
cavity,  which  the  veins  from  the  lungs  afford  in  that 
place.  The  sides  of  this  muscular  cavity  are  thicker 
than  the  sides  of  the  right  auricle,  in  about  that 
proportion,  in  which  the  left  ventricle  of  the  heart 
is  stronger  than  the  right  j their  uses  being  to  re- 
ceive blood  from  the  veins  that  lead  to  the  heart, 
and  press  it  into  the  ventricles,  a strength  in  each  au- 
ricle proportionable  to  the  strength  of  the  Ventricle 
that  it  is  to  fill  with  blood,  seems  necessary  : and 
this  different  thickness  of  the  coats  of  the  auricles 
makes  the  blood  in  the  left,  which  is  thickest,  ap- 
pear through  it  of  a paler  red ; but  when  it  is  let 


HEART. 


179 


out  of  the  auricles,  it  appears  alike  from  both  ; which 
they  would  do  well  to  examine,  who  affirm  the 
blood  returns  from  the  lungs  of  a more  florid  col- 
our than  it  went  in  ; and  offer  it  as  an  argument 
of  the  blood’s  being  mixed  with  air  in  the  lungs. 
The  ventricles  or  cavities  in  the  heart  which  receive 
the  blood,  are  hollow  muscles,  or  two  cavities  in 
one  muscle,  whose  fibres  intersect  one  another,  so 
as  to  make  the  pressure  of  the  heart  upon  the  blood 
more  equal  and  effectual,  and  are  also  less  liable  to 
be  separated  than  they  would  have  been,  if  they  had 
lain  in  one  direction.  Both  these  cavities  receiv- 
ing the  same  quantities  of  blood  in  the  same  times, 
and  always  acting  together,  must  be  equal  in  size, 
if  they  equally  discharge  what  they  contain  at  every 
systole,  as  I doubt  not  but  they  do  ; nevertheless, 
the  left  appears  less  than  the  right,  it  being  found 
empty  in  dead  bodies,  and  the  right  usually  full  of 
blood  ; which  made  the  ancients  think  the  veins 
and  the  right  ventricle  only  were  for  the  blood  to 
move  in,  and  that  the  left  and  the  arteries  contain- 
ed only  animal  spirits.  The  left  ventricle  is  much 
the  thickest  and  strongest,  its  office  being  to  drive 
the  blood  through  the  whole  body,  while  the  right 
propels  it  through  the  lungs  only.  Over  the  en- 
trance of  the  auricles  in  each  ventricle,  are  placed 
valves  to  hinder  the  return  of  blood  while  the  heart 
contracts.  Those  in  the  right  ventricle  are  named 
tricuspides,  those  in  the  left  mitrales.  One  of  these 
last  seems  to  do  further  service,  by  covering  the 


180 


HEART. 


mouth  of  the  aorta  while  the  ventricle  fills  ; which 
suffering  none  of  the  blood  to  pass  out  of  this  ven- 
tricle into  the  aorta  before  the  ventricle  acts,  it  will 
be  able  to  give  greater  force  to  the  blood  than  it 
otherwise  might  have  done  ; because  a greater  quan- 
tity of  blood  more  fully  distending  the  ventricle, 
and  making  the  greater  resistance,  it  will  be  capa- 
ble of  receiving  the  greater  impressed  force  from 
the  ventricle  ; and  if  the  blood  is  no  way  hindered 
in  the  right  ventricle  from  getting  into  the  pulmo- 
nary artery,  while  the  ventricle  dilates,  as  it  is  in  the 
left,  the  left  then  may  be  somewhat  bigger  than 
the  right,  if  they  both  empty  themselves  alike  in 
every  systole.  Though  the  auricles  of  the  heart 
are  equal  to  each  other,  and  the  two  ventricles  also 
equal  or  nearly  equal,  yet  the  auricles  are  not  so 
large  as  the  ventricles ; for  the  ventricles  contain 
not  only  ail  the  blood  which  flowed  from  the  veins 
into  the  auricles,  during  the  contraction  of  the  heart, 
but  also  that  which  flows  (which  will  be  directly 
into  the  heart)  while  the  auricles  contract,  and  the 
ventricles  dilate  ; which  leads  us  to  the  exact  knowl- 
edge of  the  use  of  the  auricles.  If  the  systole  and 
diastole  of  the  heart  are  performed  in  equal  times, 
then  the  auricles  must  be  half  the  size  of  the  ven- 
tricles ; or  whatever  proportion  the  space  of  time, 
of  the  systole  of  the  heart  bears  to  the  space  in 
which  the  systole  and  diastole  arc  both  performed, 
that  proportion  will  the  cavities  of  the  auricles 
frear  to  the  cavities  of  the  ventricles.  The  inne? 


HEART. 


181 

fibres  of  each  ventricle  are  disposed  into  small  cords, 
which  are  called  columns  : from  some  of  these 
stand  small  portions  of  flesh  called  papillae  ; these 
papillae  are  tied  to  the  valves  by  slender  fibres, 
whereby  they  keep  the  valves  from  being  pressed 
into  the  auricles  by  the  action  of  the  blood  against 
them  - in  the  systole  of  the  heart  : and  when  that 
is  over,  the  blood  flowing  in  between  them  opens 
them,  as  the  pressure  of  blood  on  the  other  side 
shuts  them  in  the  systole.  For  the  course  of  the 
blood  through  this  part,  vid.  chap.  Of  the  course 
of  the  aliment  and  fluids.  In  the  beginning  of 
each  artery  from  the  heart  are  placed  three  valves, 
which  look  forward,  and  close  together  to  hinder 
a regress  of  blood  into  the  ventricles.  Those  in 
the  pulmonary  artery  are  named  sigmoidales,  those 
in  the  aorta,  semilunares.  For  the  canalis  arteri- 
osus, vid.  chap.  Of  the  foetus. 

In  a boy  I found  a great  quantity  of  pus  in  the 
pericardium,  and  the  basis  of  the  heart  ulcerated. 
In  persons  that  have  died  of  a dropsy,  I have  usu- 
ally observed  the  heart  large,  its  fibres  lax,  and  the 
vessels  about  it  immoderately  distended,  and  poly- 
puses sometimes  in  both  auricles  and  ventricles, 
and  in  the  large  veins  ; but  more  frequently  in 
the  right  auricle  and  ventricle.  Mr.  Pile  has 
prepared  a heart  thus  diseased,  whose  circumfer- 
ence from  the  vertex  round  the  base  of  the  auri- 
cles measures  twenty  four  inches  and  a quarter, 
and  round  the  base  of  the  ventricles  seventeen 


182  HEART. 

inches  and  a half.  I dissected  a man  that  died 
tabid,  in  whom  the  pericardium  universally  ad* 
hered  to  the  heart,  and  a portion  of  the  muscular 
part  of  the  heart  was  ossified  as  large  as  a six- 
pence. The  beginning  of  the  aorta  is  frequently 
seen  ossified,  especially  in  aged  persons.  In  a wom- 
an that  died  of  a dropsy,  I found  the  valves  of  the 
aorta  quite  covered  with  chalk  stones,  which  not 
suffering  the  valves  to  do  their  office,  the  left 
ventricle  of  the  heart  was  constantly  overcharged 
with  blood,  and  distended  to  above  twice  its  nat* 
ural  bigness,  which,  I imagine,  destroyed  the  econ- 
omy of  the  body,  and  occasioned  the  dropsy. 

Upon  opening  the  body  of  a person,  who  died 
with  excessive  palpitations  of  the  heart  and  un- 
even pulse,  which  began  after  very  hard  drinking, 
in  extreme  hot  weather,  some  years  before,  I 
found  about  ten  inches  of  the  aorta  nearest  the 
heart  distended  three  times  its  natural  diameter  ; 
and  in  a man  one  hundred  and  three  years  old,  I 
found  the  same  part  of  the  aorta  extended  twice 
its  natural  capacity,  without  any  symptom  of  such 
a disorder  when  living. 


ARTERIES  AND  VEINS. 


183 


CHAPTER  VIII. 

OF  THE  ARTERIES  AND  VEINS. 

F ROM  the  right  ventricle  of  the  heart  arises  the 
pulmonary  artery,  which  soon  divides  into  two 
branches,  one  to  each  lobe  of  the  lungs  ; then 
they  subdivide  into  smaller  and  smaller  branches, 
until  they  are  distributed  through  every  part  of  the 
lungs.  From  the  extreme  branches  of  the  pulmo- 
nary artery  arise  the  small  branches  of  the  pulmo- 
nary veins  ; which,  as  they  approach  the  left  auri- 
cle of  the  heart,  unite  in  such  a manner  as  the  pul- 
monary artery  divides  going  from  the  heart,  only 
that  the  veins  enter  the  muscular  appendix  of  the 
left  auricle  in  several  branches,  and  the  blood  being 
brought  back  from  the  lungs  by  these  vessels  to  the 
left  auricle  and  ventricle  of  the  heart,  it  is  from  the 
left  ventricle  of  the  heart  thrown  into  the  aorta. 

Aorta,  or  great  artery,  arises  from  the  left 
ventricle  of  the  heart,  and  deals  out  branches  to  ev- 
ery part  of  the  body.  The  first  part  of  this  vessel 
is  called  aorta  ascendens : it  passes  over  the  left 
pulmonary  artery,  and  veins,  and  branch  of  the  as- 
pera  arteria,  and  being  reflected  under  the  left  lobe 
of  the  lungs,  it  commences  aorta  descendens ; which 
name  it  keeps  through  the  thorax  and  abdomen, 
where  it  passes  on  the  left  side  of  the  spine,  till  its 


184  ARTERIES  AND  VEINS. 

division  into  iliac  arteries  between  the  third  and 
fourth  vertebrae  of  the  loins. 

From  under  two  of  the  semilunar  valves  of  the 
aorta,  which  is  ere  it  leaves  the  heart,  arise  two 
branches  (sometimes  but  one)  which  are  bestowed 
upon  the  heart,  and  are  called  coronarke  cordis* 
From  the  curved  part  of  the  aorta,  which  is  about 
two  or  three  inches  above  the  heart,  arise  the  sub- 
clavian and  carotid  arteries  ; the  right  subclavian 
and  carotid  in  one  trunk,  but  the  left  single.  By 
some  authors  these  vessels  have  been  described  in 
a different  manner ; but  I believe  their  descrip- 
tions were,  for  want  of  human  bodies,  taken  from 
brutes ; for  I have  never  yet  seen  any  variety  in 
these  vessels  in  human  bodies,  though  I have  in 
the  veins  nearer  the  heart : and  indeed  there  seems 
to  me  to  be  a mechanical  reason  for  their  going  off 
in  the  manner  here  described,  in  human  bodies ; 
for  the  right  subclavian  and  carotid  arteries  neces- 
sarily going  off  from  the  aorta  at  a much  larger  an- 
gle than  the  left,  the  blood  would  move  more  free- 
ly into  the  left  than  the  right,  if  the  right  did  not 
go  off  in  one  trunk,  which  gives  less  friction  to  the 
blood  than  two  branches  equal  in  capacity  to  that 
one ; so  that  the  advantage  the  left  have  by  going 
off  from  the  aorta  at  much  acuter  angles  than  the 
right,  is  made  up  to  the  right  by  their  going  off  at 
first  in  but  one  branch. - 

The  carotid  arteries  run  on  both  sides  the  la- 
rynx to  the  sixth  foramina  of  the  scull,  through 


ARTERIES  AND  VEINS. 


185 


which  they  enter  to  the  brain ; but  as  they  pass 
through  the  neck,  they  detach  branches  to  every 
part  about  them,  which  branches  are  called  by  the 
names  of  the  parts  they  are  bestowed  upon  ; as, 
kryngeae,  thyroideae,  pharyngeae,  linguales,  tem- 
porales,  occipitales,  faciales,  &c.  but  just  before  they 
enter  the  sixth  foramina  of  the  scull,  they  each 
send  a small  branch  through  the  fifth  foramina  to 
that  part  of  the  dura  mater  which  contains  the 
cerebrum.  It  is  these  arteries  which  make 
those  impressions  which  are  constantly  observed  on 
the  inside  of  the  ossa  bregmatis  : these  branches, 
Mr.  Monro  observes,  oftener  arise  from  the  tempo- 
ral arteries.  The  internal  carotids  send  two  branch- 
es to  the  back  part  of  the  nose,  and  several  branches 
through  the  first  and  second  foramina  of  the  scull 
to  the  face  and  parts  contained  within  the  orbits  of 
the  eyes,  and  then  piercing  the  dura  mater,  they 
each  divide  into  two  branches,  one  of  which  they 
send  under  the  falx  of  the  dura  mater,  between  the 
two  hemispheres  of  the  brain,  and  the  other  be- 
tween the  anterior  and  posterior  lobes.  These 
branches  take  a great  many  turns,  and  divide  into 
very  small  branches  in  the  pia  mater  before  they  en- 
ter the  brain,  as  if  the  pulse  of  larger  arteries  would 
make  too  violent  an  impression  on  so  tender  and 
delicate  a part.  And  perhaps  it  may  be  from  an 
increase  of  the  impulse  of  the  arteries  in  the  brain, 
which  strong  liquors  produce,  that  the  nerves  are 
so  much  interrupted  in  their  uses  throughout  the 


a a 


186 


ARTERIES  AND  VEINS'. 


whole  body,  when  a man  is  intoxicated  with  drink*’ 
ing ; and  may  it  not  also  be  from  a like  cause  that 
men  are  delirious  in  fevers  ? Besides  these  two  ar- 
teries, viz.  the  carotids,  the  brain  has  two  more, 
called  cervicales,  which  arise  from  the  subclavian 
arteries,  and  ascend  to  the  head  through  the  fora- 
mina, in  the  transverse  processes  of  the  cervical 
vertebrae,  and  into  the  scull  through  the  tenth  or 
great  foramen.  These  two  arteries  uniting  soon 
after  their  entrance,  they  give  oil  branches  to  the 
cerebellum,  and  then  passing  forward,  divide  and 
communicate  with  the  carotids  ; and  the  carotid  ar- 
teries communicating  with  each  other,  there  is  an 
entire  communication  between  them  all ; and  these 
communicant  branches  are  so  large  that  every  one 
of  these  four  great  vessels,  with  all  their  branches, 
may  be  easily  filled  with  wax  through  any  one  of 
them. 

The  subclavian  arteries  are  each  continued  to 
the  cubit  in  one  trunk,  which  is  called  axillaris  as 
it  passes  the  arm  pits,  and  humeralis  as  it  passes  by 
the  inside  of  the  os  humeri,  between  the  muscles 
that  bend  and  extend  the  cubit.  From  the  sub- 
clavians  within  the  breast  arise  the  arteriae  mamma- 
rite,  which  run  on  the  inside  of  the  sternum,  and 
lower  than  the  cartilago  ensiformis.  Soon  after  the 
arteria  humeralis  has  passed  the  joint  of  the  cubit, 
it  divides  into  two  branches,  called  cubitalis  superi- 
or, and  cubitalis  inferior  ; which  latter  soon  sends  off 
a branch,  called  cubitalis  media,  which  is  bestowed. 


ARTERIES  AND  VEINS. 


187 


$ipon  the  muscles  seated  about  the  cubit.  The 
cubitalis  superior  passes  near  the  radius,  and  round 
the  root  of  the  thumb,  and  gives  one  branch  to 
the  back  of  the  hand,  and  two  to  the  thumb  ; one 
to  the  first  finger  and  a branch  to  communicate 
with  the  cubitalis  inferior.  The  cubitalis  inferior 
passes  near  the  ulna  to  the  palm  of  the  hand,  where 
it  takes  a turn,  and  sends  one  branch  to  the  outside 
of  the  little  finger,  another  between  that  and  the 
next  finger,  dividing  to  both,  another  in  the  same 
manner  to  the  two  middle  fingers,  and  another  to 
the  two  fore  fingers.  These  branches  which  are 
bestowed  on  the  fingers  run  one  on  each  side  of 
each  finger  internally  to  the  top,  where  they  have 
small  communications,  and  very  often  there  is  a 
branch  of  communication  between  the  humeral 
and  inferior  cubital  arteries.  This  communicant 
branch  is  sometimes  very  large,  and  liable  to  be 
pricked  by  careless  or  injudicious  blood  letters,  in 
bleeding  in  the  basilic  vein,  immediately  under 
which,  as  far  as  I have  been  able  to  observe,  this 
branch  always  lies.  Mr.  Monro  has  found  the 
subclavian  artery  divided,  in  one  subject,  into  two, 
the  exterior  of  which  formed  the  cubitalis  superi- 
or, and  the  inner  artery,  the  cubitalis  inferior ; from 
which  structure  he  accounts  for  the  success  in  the 
operation  of  the  aneurism  sometimes  performed 
above  the  cubit.  When  the  operation  for  an 
aneurism  is  made  upon  this  communicant  branch, 
it  is  found  necessary  to  tie  it  on  both  sides  of  the 


188 


ARTERIES  AND  VEINS. 


orifice,  because  the  blood  is  liable  to  flow  freely  into 
it  either  way. 

From  the  descending;  aorta  on  each  side  is  sent 
a branch  under  every  rib,  called  intercostalis,  and 
about  the  fourth  vertebra  of  the  back  it  sends  off 
two  branches  to  the  lungs,  called  bronchiales,  which 
are  sometimes  both  given  off  from  the  aorta,  some- 
times one  of  them  from  the  intercostal  of  the  fourth 
rib  on  the  right  side  ; and  as  the  aorta  passes  under 
the  diaphragm,  it  sends  two  branches  into  the  dia- 
phragm, called  arterise  phrenicae,  which  some- 
times rise  in  one  trunk  from  the  aorta,  and  some- 
times from  the  cceliaca  ; but  oftener  the  right  from 
the  aorta,  and  the  left  from  the  cceliaca.  Immedi- 
ately below  the  diaphragm  arises  the  coeliac  artery 
from  the  aorta ; it  soon  divides  into  several  branch- 
es, which  are  bestowed  upon  the  liver,  pancreas, 
spleen,  stomach  omentum,  and  duodenum.  These 
branches  are  named  from  the  parts  they  are  bestow- 
ed on,  except  two  that  are  bestowed  upon  the  stem- 
ach,  which  are  called  coronaria  superior  and  infe- 
rior, and  the  branch  bestowed  upon  the  duodenum, 
which  is  named  intestinalis.  At  a very  small  dis- 
tance below  the  arteria  cceliaca  from  the  aorta  arises 
the  mesenterica  superior,  whose  branches.are  bestow- 
ed upon  all  the  intestinum  jejunum  and  ilium,  part  of 
the  colon,  and  sometimes  one  branch  upon  the  liver. 
A little  lower  than  the  superior  mesenteric  artery 
arise  the  emulgents,  which  are  the  arteries  of  the  kid- 
neys. And  a little  lower  than  the  emulgents,  for- 


ARTERIES  AND  VEINS, 


189 


ward  from  the  aorta,  arise  the  arterix  spermaticae  ; 
for  which,  vid.  chap.  Of  the  parts  of  generation 
in  men.  Lower  laterally  the  aorta  sends  branches 
to  the  loins,  called  lumbales  ; and  one  forward,  to 
the  lower  part  of  the  colon  and  the  rectum,  called 
mesenterica  inferior.  Between  the  arteria  cceli- 
aca,  mesenterica  superior  and  inferior,  and  the 
branches  of  each  near  the  guts,  there  are  large 
communicant  branches  to  convey  the  blood  from 
one  to  another,  when  they  are  either  compressed 
by  excrements,  or  from  any  other  cause. 

As  soon  as  the  aorta  divides  upon  the  loins,  it 
sends  off  an  artery  into  the  pelvis  upon  the  os  sa- 
crum, called  arteria  sacra,  and  the  branches  the 
aorta  divides  into  are  called  iliacx,  which  in  about 
two  inches  space  divide  into  external  and  internal. 
The  iliacae  interns  first  send  off  the  umbilical  ar- 
teries, which  are  dried  up  in  adult  bodies,  except  at 
their  beginnings,  which  are  kept  open  for  the  col- 
lateral branches  on  each  side,  one  to  the  bladder, 
and  one  to  the  penis  in  men,  and  in  women  the 
uterus : the  rest  of  these  branches  are  bestowed  up- 
on the  buttocks  and  upper  parts  of  the  thighs. 
The  iliacx  externx  run  over  the  ossa  pubis  into 
the  thighs  ; and  as  they  pass  out  of  the  abdomen 
they  send  off  branches,  called  epigastricx  to  the 
fore  part  of  the  integuments  of  the  abdomen  un- 
der the  recti  muscles.  And  the  epigastric  arteries 
send  each  a branch  into  the  pelvis,  and  through  the 
foramina  of  the  ossa  innominata  to  the  muscles 


190 


ARTERIES  AND  VEINS. 


thereabouts.  As  soon  as  the  iliac  artery  is  passed 
out  of  the  abdomen  into  the  groin  it  is  called  in- 
guinalis,  and  in  the  thigh  cruralis,  where  it  sends 
a large  branch  to  the  back  part  of  the  thigh  ; but 
the  great  trunk  is  continued  internally  between 
the  flexors  and  extensors  of  the  thigh,  and  passing 
through  the  insertion  of  the  triceps  muscle  into  the 
ham,  it  is  there  called  poplitea  ; then  below  the 
joint  it  divides  into  two  branches,  one  of  which  is 
called  tibialis  antica  ; it  passes  between  the  tibia 
and  fibula  to  the  fore  part  of  the  leg,  and  is  be- 
stowed upon  the  great  toe,  and  one  branch  to  the 
next  toe  to  the  great  one,  and  another  between 
these  toes,  to  communicate  with  the  tibialis  posti- 
ca  ; which  artery,  soon  after  it  is  divided  from  the 
antica,  sends  off  the  tibialis  media,  which  is  bestow- 
ed upon  the  muscles  of  the  leg  $ the  tibialis  postica 
goes  to  the  bottom  of  the  foot  and  all  the  lesser 
toes.  The  tibialis  antica  is  disposed  like  the  cubita- 
lis  superior  ; the  postica  like  the  cubitalis  inferior  ; 
and  the  mediae  in  each  have  also  like  uses.  These 
arteries  which  I have  described,  are  uniform  in  most 
bodies,  but  the  lesser  branches  are  distributed  like 
the  branches  of  trees,  in  so  different  a manner  in 
one  body  from  another,  that  it  is  highly  probable 
no  two  bodies  are  exactly  alike,  nor  the  two  sides 
in  any  one  body. 

I have  once  seen  a rupture  of  matter,  and  once 
of  blood  and  matter,  which  flowed  out  of  the  ab- 
domen into  the  fore  part  of  the  thigh,  through  the 


Arteries  and  veins* 


191 


Same  passage  at  which  the  iliac  artery  goes  out  o£ 
the  abdomen. 

The  veins  arise  from  the  extremities  of  the  ar- 
teries, and  make  up  trunks  which  accompany  the 
arteries  in  almost  every  part  of  the  body,  and  have 
the  same  names  in  the  several  places  which  the  ar- 
teries have,  which  they  accompany.  The  veins  of 
the  brain  unload  themselves  into  the  sinuses  (vid. 
chap.  Of  the  dura  and  pia  mater)  and  the  sinuses 
into  the  internal  jugulars  and  cervicals  ; and  the 
internal  jugulars  and  cervicals  into  the  subclavians, 
which  joining,  make  the  cava  descendens.  The 
internal  jugulars  are  seated  by  the  carotid  arteries, 
and  receive  the  blood  from  all  the  parts  which  the 
carotids  serve,  except  the  hairy  scalp  and  part  of 
the  neck,  whose  veins  enter  into  the  external  ju- 
gulars, which  run  immediately  under  the  musculus 
quadratus  gense,  often  two  on  each  side.  The  cer- 
vical veins  descend  two  through  the  foramina  in  the 
transverse  processes  of  the  cervical  vertebrae,  and  two 
through  the  great  foramen  of  the  spine,  and  one  on 
each  side  the  spinal  marrow  ; these  join  at  the  low- 
est vertebra  of  the  neck,  and  then  empty  into  the 
subclavians,  and  at  the  interstices  of  all  the  vertebrae 
communicate  with  one  another. 

The  veins  of  the  limbs  are  more  than  double 
the  number  of  the  arteries,  there  being  one  on  each 
side  each  artery,  even  to  the  smallest  branches  that 
we  can  trace,  besides  the  veins  which  lie  immedi- 
ately under  the  skin.  Those  which  accompany  the 


192  ARTERIES  AND  VEINS. 

arteries,  have  the  same  names  with  the  arteries  ; 
those  which  run  immediately  under  the  skin  on  the 
back  of  the  hand,  have  no  proper  names  ; they  run 
from  thence  to  the  bend  of  the  elbow,  where  the  up- 
permost  is  called  cephalica,  the  next  mediana,  the 
next  basilica.  These  all  communicate  near  the  joint, 
of  the  elbow,  and  then  send  one  branch  which  is 
more  directly  from  the  cephalica,  and  bears  that 
name  until  it  enters  the  subclavian  vein  ;•  it  passes 
immediately  under  the  skin,  in  most  bodies,  be- 
tween the  flexors  and  extensors  of  the  cubit,  on  the 
upper  side  of  the  arm.  The  other  branches  joining, 
and  receiving  those  which  accompany  the  arteries 
of  the  cubit,  they  pass  with  them  by  the  artery 
of  the  arm  into  the  subclavian  vein.  The  external 
veins  have  frequent  communications  with  the  in- 
ternal, and  are  always  fullest  when  we  use  the 
most  exercise  ; because  the  blood  being  expanded 
by  the  heat  which  exercise  produces,  it  requires  the 
vessels  to  be  distended  j and  the  inner  vessels  being 
compressed  by  the  actions  of  the  muscles,  they 
cannot  dilate  enough  ; but  these  vessels  being  seat- 
ed on  the  outsides  of  the  muscles,  are  capable  of 
being  much  dilated  ; and  this  seems  to  me  to  be  the 
chief  use  of  these  external  vessels.  The  cephalic 
vein,  as  it  runs  up  the  arm,  is  very  visible  in  most 
men,  but  in  children  is  rarely  to  be  seen ; there- 
fore ureat  care  should  be  taken  not  to  wound  it  in 

O 

the  cutting  of  issues  in  children’s  arms  ; and  I know- 
no  way  to  be  sure  of  avoiding  it,  but  by  cutting  the 


ARTEP.IE9  AND  VEINS'. 


193 


issue  more  externally  than  is  usual  in  men,  which 
may  be  done  without  any  inconvenience. 

In  the  thorax,  besides  the  two  cavae,  there  is  a 
vein  called  azygos,  or  vena  sine  pari ; it  is  made  up 
of  the  intercostal,  phrenic,  and  bronchial  veins, 
and  enters  the  descending  cava  near  the  auricle, 
as  if  its  use  was  to  divert  the  descending  blood 
from  falling  too  directly  upon  the  blood  in  the 
ascending  cava,  and  direct  the  blood  of  the  de- 
scending cava  into  the  auricle. 

In  the  abdomen  (besides  the  cava  ascendens  and 
the  veins  which  are  named  like  the  arteries,  viz. 
the  emulgents  from  the  kidneys,  the  lumbal  and 
spermatic  veins,  the  sacra,  iliac,  and  hypogastric 
veins)  there  is  one  large  one  called  vena  portae, 
whose  branches  arise  from  all  the  branches  of  the 
cceliac  and  two  mesenteric  arteries,  except  those 
branches  of  the  coeliac  and  superior  mesenteric, 
which  are  bestowed  on  the  liver,  and  uniting  in 
one  trunk  enters  the  liver,  and  is  there  again  dis- 
tributed like  an  artery,  and  has  its  blood  collected 
and  brought  into  the  cava  by  the  branches  of  the 
cava  in  the  liver  ; this  vein  being  made  use  of  in- 
stead of  an  artery  to  carry  blood  to  the  liver,  for 
the  separation  of  bile.  It  moves  here  about  eight 
times  slower  than  in  the  arteries  hereabouts  ; and 
this  slow  circulation  being  supposed  necessary,  I 
think,  there  seems  no  other  way  so'  fit  to  procure 
it  ; for  if  an  artery  had  been  employed  for  this  use, 
and  been  thus  much  dilated  in  so  short  a passage, 
Bb 


Arteries  and  veins'. 


194 

the  blood  would  not  have  moved  so  uniformly  in 
it,  but  faster  through  its  axis  than  near  its  sides  ; 
and  besides,  it  is  very  probable  that  the  blood  in 
this  vein,  having  been  first  employed  in  nourish- 
ing several  parts,  and  having  through  a long  space 
moved  slowly,  may  be  made  thereby  fitter  for  the 
separation  of  bile,  than  blood  carried  by  an  artery 
dilated  to  procure  a circulation  of  the  same  velocity 
with  that  in  this  vein. 

In  the  leg  the  veins  accompany  the  arteries  in 
the  same  manner  as  in  the  arm,  the  external  veins 
of  the  foot  being  on  the  upper  side,  and  from  them 
is  derived  one  called  saphena,  which  is  continued 
on  the  inside  of  the  limb  its  whole  length,  and 
has  several  names  given  it  from  the  several  places 
through  which  it  passes. 

The  arteries  have  three  coats  ; a middle  mus- 
cular, and  an  external  and  internal  membranous. 
The  veins  are  said  to  have  the  same ; the  internal 
coat  of  an  artery  may  be  pretty  easily  separated,  but 
not  the  external ; and  though  the  veins  have  mus- 
cular fibres,  yet  I could  never  separate  any  one  dis- 
tinctly into  three  coats  ; and  in  the  inside  of  the 
veins  there  are  many  valves,  especially  in  the  low- 
er limbs,  to  hinder  any  reflux  of  the  venal  blood, 
which  otherwise  would  have  happened  from  the 
frequent  actions  of  the  muscles  on  the  outsides  of 
the' veins  ; and  both  the  arteries  and  veins,  as  they 
run  in  the  inside  of  the  limb,  or  as  they  are  dis- 
persed in  parts  that  suffer  great  extensions,  as  the 


Arteries  and  veins- 


I9S 


stomach,  guts,  and  uterus,  they  are  curved  so 
much  as  that  when  these  parts  come  to  be  distend- 
ed, they  may  comply  with  those  distensions  by  only 
being  straitened,  and  so  preserved  from  being 
stretched,  which  would  lessen  their  diameters.  The 
small  arteries  near  the  heart  go  off  from  the  large 
trunks  at  obtuse  angles,  farther  at  less  obtuse  angles., 
then  at  right  angles,  farther  still  at  acute  angles, 
and  near  the  extremities  at  very  acute  angles,  be- 
cause die  blood  in  the  vessels  far  from  the  heart 
moi  ing  with  less  velocity  than  the  blood  in  the 
vessels  near  the  heart,  the  blood  in  the  collateral 
branches  more  remote  from  the  heart  wants  the 
advantage  of  a directer  course  ; and  because  a very 
large  branch  arising  out  of  another,  might  weaken 
too  much  the  sides  of  the  vessel  it  would  arise  from, 
that  inconvenience  is  prevented  by  increasing  the 
number,  and  so  lessening  the  size  of  the  collateral 
branches,  where  otherwise  one  large  branch  would 
have  served  better  ; as  in  the  going  off  of  the  sub- 
clavian and  carotid  arteries,  which  might  have  gone 
off  for  some  space  in  one  trunk  ; but  this  mechan- 
ism is  more  evident  in  the  going  off  of  the  arteria 
coeliaca  and  mesenterica  superior.  And  the  small 
arteries  always  divide  so  as  that  the  lesser  branch 
may  lie  least  in  the  direction  of  the  blood  flowing 
into  diem,  which  makes  the  blood  flow  most  freely 
into  that  branch  that  hath  farthest  to  carry  it  ; and 
the  smaller  branches  arise  more  or  less  obliquely 
from  the  sides  of  other  arteries,  according  to  the 


196 


ARTERIES  AND  VEINS. 


proportion  they  bear  to  the  arteries  they  arise  from, 
because  an  artery  comparatively  large  arising  ob- 
liquely from  the  side  of  another,  would  make  an 
orifice  in  that  it  arises  from  too  large,  and  weaken 
it.  And  both  these  ends  are  at  once  brought  about, 
by  making  the  arteries,  that  give  off  the  branches, 
bend  more  or  less  toward  the  branches  they  give 
off,  according  to  the  comparative  magnitude  of  the 
branches  given  off. 

Borelli  has  computed  the  force  which  the 
heart  exerts  at  every  systole,  to  be  equal  to  three 
thousand  pounds  weight,  and  the  force  which  all 
the  arteries  exert  at  every  systole,  to  be  equal  to 
sixteen  thousand  pounds  weight,  and  that  they  to- 
gether overcome  a force  equal  to  an  hundred  and 
thirty  six  thousand  pounds  weight  ; and  Dr.  Keil 
has  computed  that  the  heart  in  every  systole  exerts 
a force  not  exceeding  eight  ounces.  The  first  com- 
putation was  made  by  comparing  the  heart  with 
other  muscles,  whose  power  to  sustain  a weight  could 
be  best  determined  ; and  the  latter  was  made  from 
the  velocity  of  the  blood  moving  in  an  artery  : 
therefore  if  we  consider  that  Borelli’s  way  of 
computing  led  him  to  find  out  the  absolute  force  of 
the  heart,  and  Dr.  Kiel’s  the  force  which  the  heart 
usually  exerts,  perhaps  these  very  different  compu- 
tations may  be  accounted  for  ; for  if  the  force  of 
the  heart,  which  is  constantly  exerted,  should,  com- 
pared with  any  other  muscle,  be  but  in  a reciprocal 
proportion  to  the  frequency  of  their  actions,  and 


ARTERIES  AND  VEINS. 


197 


the  importance  of  their  uses  ; may  not  the  heart 
very  fitly  have  a force  vastly  greater  than  usually  it 
exerts,  because  it  is  always  in  action,  and  must  be 
able  to  exert  a certain  force  in  the  lowest  state  of 
health  ? What  force  the  heart  ever  exerts  in  a grown 
man,  I cannot  say ; but  it  must  be  less  in  each  ven- 
tricle than  is  sufficient  to  burst  the  valves,  which 
hinder  the  blood  from  returning  into  the  auricles 
out  of  the  ventricles,  or  than  is  sufficient  to  break 
those  threads  by  which  these  valves  are  tied  to  the 
papillse.  In  a dog,  I found  the  force  which  the 
heart  would  exert,  would  not  raise  to  one  foot  per- 
pendicular height  a column  of  blood  through  the 
aorta  ascendens.  And  when  I inject  the  arteries  of 
a child,  I find  a force  exceeding  little  will  throw 
water  through  all  the  vessels,  with  a velocity  equal 
to  that  with  which  the  blood  moves  in  those  vessels 
when  living.  And  if  the  heart,  like  other  muscles, 
can  perform  the  first  part  of  its  contraction  with 
most  ease,  are  not  the  quick  actions  of  the  heart  in 
hectic  fevers  owing  to  its  not  being  able  to  empty 
the  ventricles  every  systole,  which,  I think,  will 
oblige  it  to  act,  aeteris  paribus,  so  much  the  often- 
er  ? For  the  following  ingenious  attempt  to  ac- 
count for  the  systole  and  diastole  of  the  heart,  and 
the  reciprocal  actions  of  the  auricles  and  ventricles, 
I am  obliged  to  Mr.  Monro. 

c<  Postulata,  that  the  action  of  the  muscles  de- 
<(C  pends  on  the  influx  of  blood  and  liquidum  ner- 
^ vosum  into  the  muscular  fibres,  and  therefore, 


198 


ARTERIES  AND  VEINS. 


p4  whenever  the  muscles  are  deprived  of  either  or 
44  both  these  fluids,  their  action  ceases ; this  a great 
44  many  authors  have  fully  proved  by  tying  and 
4:4  cutting  the  nerves  and  arteries  that  serve  any 
44  muscle.  That  all  muscles  are  in  a constant  state 
44  of  contraction  as  long  as  the  blood  and  liquidum 
4C  nervosum  are  freely  supplied  to  them,  which 
44  seems  evident  from  the  sphincter  ani  and  vesiae, 
44  and  from  the  continued  contraction  of  such  mus- 
44  cles,  whose  antagonists  are  cut  asunder,  .or  pa- 
44  ralytic.  That  the  nerves  of  the  heart  run  to  it 
“ between  the  auricles  and  arteries,  and  that  the 
44  arteriae  coronarke  rise  from  the  aorta  behind  the 
•t4  valvulce  semiiunares,  both  which  are  evident  from 
44  dissections.  If  then  both  auricles  and  ventricles 
44  are  ready,  upon  the  first  communication  of  mo- 
44  tion,  to  contract  at  the  same  time,  the  ventricles, 
44  as  Dr.  Keil  well  observes,  being  stronger,  will 
44  first  contract,  and  hinder  the  contraction  of  the 
44  auricles,  which  must  be  in  the  mean  time  much 
44  dilated  by  the  influx  of  blood  from  the  veins, 
44  while  the  arteries  are  also  distended  by  the  blood 
44  thrown  out  of  the  ventricles ; therefore  the  car- 
j4c  diac  nerves  lying  between  the  two  will  be  com- 
44  pressed;  and  the  coui'se  of  the  liquids  in  them  stop- 
44  ped ; at  the  same  time  the  blood  that  rushes  out 
f4  of  the  left  ventricle  into  the  aorta,  pushes  the 
44  valves  of  that  artery  upon  the  orifices  of  the  ar- 
44  tcrke  coronariae,  so  that  no  blood  can  enter  into 
44  the  substance  of  the  heart ; thus  both  causes  of 


ARTERIES  AND  VEINS. 


199 


« Contraction  failing,  this  muscle  must  become  pa- 
« ralytic.  The  resistance  then  to  the  contraction  of 
the  auricles  being  now  removed,  they  will  throw 
« their  blood  into  the  ventricles  ; and  the  impulsion 
<e  of  blood  into  the  arteries  from  the  heart  now  also 
cc  ceasing,  the  two  great  arteries  will  be  consfcrict- 
“ ed : the  nerves  are  therefore  now  again  free  from 
<£  compression,  and  the  valves  of  the  aorta  being 
i£  thrust  back  upon  the  mouth  of  the  ventricle,  the 
<£  blood  enters  the  arterise  coronariae  ; since  the  ven- 
<s  tricles  are  again  supplied  with  both  the  liquids 
“ on  which  their  contraction  depends,  they  must 
“ again  act.  And  thus  as  long  as  these  causes  con- 
C£  tinue,  their  effects  must  follow,  i.  e.  as  long  as- 
s‘  the  creature  lives,  the  heart  must  have  an  al- 
<£  ternate  systole  and  diastole,  and  the  auricles  and 
“ ventricles  have  reciprocal  actions.” 

If  the  arteries  contract,  suppose  a fourth  part 
of  the  squares  of  their  diameters  at  every  systole,  and 
if  the  heart  does  not  throw  out  a quantity  at  every 
systole,  equal  to  the  fourth  part  of  the  solid  con- 
tents of  all  the  arteries  when  dilated,  it  is  evident 
the  heart  does  not  throw  the  blood  through  the 
whole  arterial  system,  but  into  so  much  of  the  ar- 
teries nearest  the  heart,  as  will  contain  four  times 
as  much  as  is  thrown  out  of  the  left  ventricle  at 
once  : and  then  this  portion  of  arteries  throws  the 
blood  forwards  and  dilates  the  arteries  that  lie  next, 
and  so  on  : but  if  the  capacities  of  all  the  arteries 
taken  together  in  their  utmost  dilatations,  exceed 


200 


arteries  and  veins. 


their  capacities  in  their  utmost  contractions,  just  Sc* 
much  as  the  quantity  of  blood  amounts  to,  which 
is  thrown  out  of  the  left  ventricle  of  the  heart  at 
every  systole,  which  I believe  is  the  case,  then  every 
contraction  of  the  heart  propels  the  blood  through 
the  whole  arterial  system,  which  may  be  the  reason 
why  the  largest  animals,  cxteris  paribus,  have  the 
slowest  pulses  and  least  vigour  in  their  motions,  and 
perhaps  too  for  the  same  reason  require  a less  pro- 
portion of  food.  The  sections  of  all  the  remoter 
vessels  being  greater  than  a section  of  the  aorta, 
the  blood  will  move  so  much  slower  in  the  lesser 
vessels  than  in  the  greater,  as  the  sections  of  the 
lesser  vessels  taken  together  exceed  the  section  of 
the  greater  vessel  or  vessels.  The  strength  of  the 
coats  of  the  arteries,  if  the  blood  pressed  equally 
against  the  sides  of  them  all,  cseteris  paribus,  ought 
to  be  one  to  another  as  their  circumferences,  be- 
cause so  much  as  the  circumference  of  one  artery 
is  greater  than  another,  so  much  greater  pressure 
its  sides  must  sustain  ; but  the  arteries  nearest  the 
heart,  sustaining  the  reaction  of  all  the  arterial 
blood,  they  must  have  a- strength  yet  greater  than 
in  that  proportion  ; and  the  vessels,  both  arteries 
and  veins,  the  more  distant  they  are  from  the 
head,  the  greater  proportional  strength  their  coats 
must  have,  because  the  arterial  and  venal  blood 
communicating,  they  will  press  upon  the  lower 
vessels,  with  a force  proportional  to  the  perpendic- 
ular altitude  of  blood  above,  which  will  be  that  of 


ARTERIES  AND  VEINS.' 


201 


the  perpendicular  altitude  of  the  whole  body  ; for 
though  the  ascending  blood  of  the  arteries  may  be 
said  not  to  press  upon  the  descending,  because  it 
moves  another  way,  nevertheless,  it  being  thrown 
from  the  heart  into  one  common  vessel,  which  af- 
terwards divides,  the  blood  moving  both  ways  com- 
municates, and  that  force  which  is  necessary  to 
overcome  the  natural  inclination  of  the  ascending 
blood  to  descend,  will  be  impressed  also  upon  the 
descending  blood,  which  is  just  the  same  with  the 
weight  of  the  ascending  blood  ; and  the  veins  both 
from  above  and  below  communicating  at  the  right 
auricle,  the  pressure  in  them  will  also  be  as  the 
perpendicular  altitude  of  the  body.  So  that  the 
blood  in  all  the  veins  and  arteries  may  be  compared 
to  a fluid  in  a curved  tube,  in  which  that  part  in 
one  leg  exactly  balances  that  in  the  other,  and  both 
pressing  most  upon  those  parts  which  are  nearest 
the  centre  of  the  earth.  Accordingly  we  And  by 
experience,  that  humours  are  most  apt  to  flow  to 
the  lowest  parts,  and  that  by  laying  those  parts  upon 
a level  with  the  whole  body,  this  inconvenience  is 
remedied  ; but  laying  a leg  only  on  a chair  does  it 
but  in  part,  just  so  much  as  the  perpendicular  alti- 
tude of  the  body  from  that  part  is  shortened.  There 
is  also  to  be  considered  concerning  the  thickness 
of  the  coats  of  the  vessels,  that  the  blood  moving 
slower  in  the  small  vessels  than  in  the  great,  the  mo- 
ment of  the  blood  against  the  sides  of  a small  vessel 
will  be  as  much  less  than  the  moment  of  the  blood 


202 


ARTERIES  AKD  VEINS. 


against  equal  parts  of  a great  one,  as  the  velocity  of 
the  blood  in  a small  vessel  is  less  than  that  in  a great 
one  ; and  therefore  their  coats  may  also  differ  from 
the  former  proportion,  as  the  velocity  of  the  blood 
differs.  Most  of  the  small  vessels  in  the  limbs  ly- 
ing against  one  another  are  a mutual  support,  and 
therefore  less  liable  to  be  dilated  or  burst  than  ca- 
pillaries which  lie  in  the  thin  membranes  of  cavi- 
ties, such  as  in  the  nose.  Hence  these,  I suppose, 
are  most  subject  to  haemorrhages.  And  if  haemor- 
rhages of  blood  do  frequently  arise  from  obstruc- 
tions in  the  minutest  vessels,  does  it  not  appear  how 
opium  and  the  bark,  if  they  thin  the  blood  inwardly 
taken  (as  they  do  most  powerfully  when  mixed 
with  it)  come  to  be  so  often  effectual  remedies  in 
that  case  ? And  the  coats  of  the  lesser  vessels  being 
proportionably  weaker  than  the  great  ones,  accord- 
ing to  the  decrease  of  the  velocity  of  the  blood, 
which  lessens  the  moment  with  which  it  moves  in 
them,  whenever  the  blood  begins  to  move  in  them 
with  an  equal  velocity,  or  greater,  as  it  happens 
after  an  amputation,  when  the  larger  vessels  are  tied, 
the  force  of  the  blood  sometimes  overcomes  the 
strength  of  the  coats  of  the  smaller  vessels,  and  di- 
lates them  so  that  those  vessels  which  scarce  bled 
during  the  operation,  will  sometimes  bleed  after- 
wards. And  this  constant  effort  of  the  blood  to 
dilate  vessels  upon  the  obstructions  of  others  may 
cause  those  throbbing  pains  which  are  felt  in 
wounds  when  the  bleeding  is  stopped,  and  in  alh 


ARTERIES  AKD  VEINS. 


203 


violent  inflammations,  until  the  collateral  branches 
are  dilated,  or  the  tension  of  the  parts  otherwise 
taken  off. 

The  extreme  branches  both  of  the  arteries  and 
veins  have  very  numerous  communications,  like 
those  in  the  stamina  of  the  leaves  of  plants,  by 
which  communications  the  blood  that  is  obstruct- 
ed  in  any  vessels  may  pass  off  by  other  vessels  that 
are  not  obstructed  5 and  the  moment  of  the  blood 
in  the  vessels  lessening,  and  the  friction  from  the 
vessels  increasing  as  it  approaches  the  extremities 
and  as  many  of  the  lesser  vessels  are  more  exposed 
to  pressure  than  any  of  the  large  ones,  those  com- 
munications in  the  lesser  vessels  are  therefore  made 
more  numerous.  By  means  of  these  communica- 
tions, the  blood  circulates  in  a limb  that  has  had 
part  amputated,  and  into  any  vessels  that  have 
been  separated  from  the  trunks  that  supplied 
them,  which  otherwise  must  have  mortified  for 
want  of  nourishment,  and  with  them,  for  the 
same  reason,  all  the  branches  that  arise  from  such 
separated  vessels  ; and  I can  discern  no  other  way 
than  by  these  communications,  that  the  fluids 
contained  in  a large  inflammation  can  suppurate 
into  one  cavity. 

If  we  inject  by  the  arteries  a large  quantity  of  a 
coloured  fluid,  we  And  all  the  large  veins  full  of 
that  liquor  before  any  of  the  solid  parts  are  much 
coloured  with  it  ; and  upon  frequent  repetitions  ail 
#fthem  much  less  coloured  than,  I think,  might  be 


204 


ARTERIES  AND  VEINS. 


expected,  if  it  had  gone  into  all  the  vessels  of  the 
body ; and  I have  often  thrown  wa$  or  tallow, 
coloured  with  vermilion  or  verdigrise,  through 
all  the  arteries,  and  back  again  through  the  veins, 
even  to  the  heart,  every  where  filling  vessels  that 
cannot  be  discerned  without  a microscope  ; and  all 
this  without  filling  or  much  discolouring  any  one 
entire  part.  In  viewing  with  a microscope  the  cir- 
cultion  of  the  blood  in  the  tail  of  a fish,  the  eye 
easily  traces  arteries  to  their  extremities,  and  their 
return  in  veins  ; yet  all  the  vessels  we  can  see  make 
but  a small  part  of  the  whole  of  what  we  see  ; 
though  we  are  taught  that  the  whole  animal  body 
is  a compages  of  vessels,  such  as  we  see  : but  if  it 
were  so,  I think,  we  could  not  well  distinguish  any  ; 
and  if  the  sum  of  the  diameters  of  all  the  vessels 
we  can  see,  are  to  that  of  the  breadths  and  thick- 
nesses of  all  the  rest  of  the  parts,  which  we  see  at 
the  same  time,  taken  together,  but  as  one  to  five, 
these  vessels  then  are  no  more  than  the  twenty 
fifth  part  of  what  we  see  with  them.  What  then 
shall  we  suppose  the  rest  of  the  tail,  and  those  parts 
which  were  so  little  tinged,  and  those  which  were 
not  filled  with  wax,  in  the  foregoing  experiments, 
composed  of  ? Are  they  not  composed  of  vessels 
which  arise  from  the  arteries,  as  excretory  ducts  do 
In  a gland,  but  terminate  in  the  veins  ? And  these 
vessels  being  only  to  convey  the  nutritious  juices, 
and  what  else  may  be  a proper  vehicle  for  them, 
is  it  not  fit  the  circulation  in  them  should  be  ex* 


ARTERIES  AND  VEINS. 


205 


ceeding  slow,  that  the  nutritious  particles  may  ad- 
here the  easier  to  the  fibres  of  the  vessels,  which 
they  are  to  augment  or  repair  ? Besides,  if  any 
whole  part  was  made  up  of  blood  vessels,  or  any 
other  vessels  with  fluids  moving  swiftly  in  them,  it 
seems  to  me  impossible,  that  one  part  of  a limb  can 
be  very  cold  while  another  part  is  hot,  if  the  warmth 
of  the  parts  is  owing  to  the  fluids  they  contain. 
And  if  there  are  such  vessels  as  these,  the  velocity 
of  the  motion  of  their  fluids  will  not  depend  upon 
any  proportion  they  bear  to  the  vessels  they  arise 
from,  but  upon  the  velocity  with  which  their  fluids 
are  separated  from  the  arteries  into  them,  and  the 
proportion  of  the  sections  of  all  their  orifices  to 
the  sum  of  their  own  sections,  at  any  distance 
where  we  would  compare  the  velocity  of  their 
fluids.  And  the  strength  of  the  coats  of  these  ves- 
sels mav  not  onlv  be  as  much  less  than  the  strength 
of  the  coats  of  on  artery,  as  their  diameters  are 
less,  but  also  less  in  that  proportion  in  which  the 
velocity  of  their  fluids  is  less,  and  the  motions  more 
uniform,  than  the  velocity  and  motion  of  the  blood 
in  an  artery. 

The  coats  of  the  veins  are  much  thinner  than 
those  of  the  arteries,  comparing  vessels  whose  sec- 
tions are  equal,  because  the  blood  moving  slower 
in  the  veins  than  in  the  arteries,  it  presses  with  less 
moment  against  their  sides  : and  besides,  the  blood 
in  the  veins  has  nearly  an  equal  uniform  motion, 
but  jn  the  arteries  a very  unequal  one  ; and  that 


206 


ARTERIES  AND  VEINS. 


will  require  a farther  difference  in  the  strength  of 
their  coats  ; for  those  of  the  arteries  must  be  equal 
to  the  greatest  natural  pressure  ; and  if  the  arterial 
blood  propels  the  venal,  that  is  a farther  reason  for 
the  different  strength  of  their  coats. 

All  these  things  being  considered,  it  appears  to 
be  a difficult  thing  to  determine  nearly,  what  pro- 
portion the  fluids  of  an  animal  body  bear  to  the 
solids,  or  what  proportion  the  sum  of  all  the  mi- 
nutest arteries  bear  to  the  aorta,  without  which,  I 
think,  we  can  neither  determine  the  comparative 
velocity  of  the  blood  moving  in  the  different  vessels, 
nor  the  quantity  of  blood  in  any  animal  body,  nor 
the  time  in  which  the  whole  mass  of  blood,  or  a 
quantity  equal  to  the  whole  mass,  is  flowing  through 
the  heart.  But  if  each  ventricle  of  the  heart  holds 
five  ounces  of  blood,  and  they  are  filled  and  emp- 
tied every  systole  and  diastole,  which,  I think,  is 
true,  and  if  eighty  pulses  in  a minute  be  allowed 
to  be  a common  number,  there  then  flows  twenty- 
five  pounds  of  blood  through  each  ventricle  of  the 
heart  in  a minute.  Dr.  Keil  has  shewn  that  the 
sum  of  all  the  fluids  in  a man,  exceed  the  sum  of 
all  the  solids,  and  yet  the  quantity  of  blood  which 
all  the  visible  arteries  of  a man  will  contain,  is  less 
than  four  pounds  ; and  if  we  may  suppose  all  the 
visible  veins,  including  the  vena  portae,  hold  four 
times  as  much,  the  whole  then  that  the  visible  ves- 
sels can  contain  is  not  twenty  pounds ; but  the  whole 
that  they  do  contain  is  but  very  little  more  than  the 


ARTERIES  AND  VEIN'S. 


207 


veins  can  contain,  seeing  the  arteries  are  always 
found  almost  empty  in  dead  bodies  ; but  how  much 
the  invisible  arteries  and  veins  contain,  I mean  those 
which  contain  such  a compound  fluid  as  is  found 
in  the  larger  vessels,  I know  no  way  to  judge,  un- 
less we  knew  what  proportion  these  vessels  bear  to 
those  that  carry  the  nutritious  juices  and  serum  (if 
there  are  such)  without  the  globuli  of  the  blood. 
Cteteris  paribus,  is  not  the  velocity  of  the  blood  in 
all  animals  proportionable  to  their  quantity  of 
action  ; and  their  necessity  of  food  also  in  propor- 
tion to  their  quantity  of  action  ? If  so,  it  appears 
how  those  animals  which  use  no  exercise,  and  whose 
blood  moves  extremely  slow  in  the  winter,  can  sub- 
sist without  any  fresh  supply  of  food  ; while  others 
that  use  a little  more  exercise,  require  a little  more 
food  ; and  those  who  use  equal  exercise  winter  and 
summer,  require  equal  quantities  of  food  at  all 
times  ; the  end  of  eating  and  drinking  being  to  re- 
pair what  exercise  and  the  motion  of  the  blood  has 
destroyed  or  made  useless  ; and  is  not  the  less  ve- 
locity of  the  blood  in  some  animals  than  in  others, 
the  reason  why  wounds  and  bruises  in  those  ani- 
mals do  not  so  soon  destroy  life,  as  they  do  in  ani- 
mals whose  blood  moves  swifter  ? 

I had  a patient  whose  muscles  on  the  inside 
of  the  thigh  were  torn  to  pieces  with  the  cramp, 
from  whence  was  a vast  effusion  of  blood  among 
the  muscles.  The  tumour  being  opened,  it  was 
judged  necessary  to  take  off  the  limb.  The  pa- 


203 


ARTERIES  AND  VEINS'. 


tient,  having  a great  discharge  from  the  wotmcf^ 
was  easy  for  about  ten  days ; but  the  cramp  then' 
returned  into  the  stump  with  such  excessive  tor- 
ment that  he  died  soon  after.  I have  never  heard 
btLt  of  one  other  case  of  this  kind,  which  ended  in 
the  same  manner. 

When  any  of  the  vessels  are  lacerated  by  bruises, 
strains,  or  otherwise,  without  any  external,  wound, 
purging  (which  is  of  more  use  than  one  can  well 
account  for)  and  cooling  applications  are  always 
proper  to  prevent  as  much  as  may  be  extravasations 
of  blood  or  serum  ; but  the  lacerations  once  healed, 
which  may  be  in  eight  or  ten  days,  and  the  pain 
quite  gone,  then  warm  medicines  may  be  applied,, 
with  opium,  or  sp.  cornu  cervi  (which  powerfully 
separate  coagulated  fluids)  to  help  to  attenuate  and 
thereby  dissipate  the  extravasated  juices. 

When  the  blood  vessels  become  unable  to  pre- 
serve the  circulation  in  the  extreme  parts,  whether 
from  particular  weakness  in  the  vessels,  or  any 
other  decay,  I have  always  observed  it  to  be  hurtful 
to  scarify.  It  lets  out  the  juices  that  should  assist 
nature  to  make  a separation  of  the  mortified  part  5 
nor  can  it  be  known  in  what  place  we  may  safely 
amputate  till  such  a separation  which  teaches  us 
where  it  can  be  supported,  and  in  any  place  short 
of  that,  an  operation  will  be  both  useless  and  mis- 
chievous. I have  known  many  succeed  well  who 
have  been  thus  left  to  separate,  but  very  few  that 
were  otherwise  treated  ; nay,  have  known  some 


LYMPII AEDUCTS. 


209 


extraordinary  instances  of  success  where  the  patient 
had  the  happiness  to  have  no  one  about  them  to  in- 
terrupt  the  kind  assistance  of  mature. 


CHAPTER  X. 

OF  THE  LYMPHiEDUCTS. 

JLi  YMPHaEDUCTS  are  small  pellucid  cylindri- 
cal tubes,  which  arise  invisible  from  the  extremi- 
ties of  the  arteries  throughout  the  whole  body, 
but  more  plentifully  in  glands  than  other  parts, 
and  in  greatest  number  from  such  glands  as  separate 
the  most  viscid  fluids,  as  may  be  observed  in  the  liver 
and  testes-  They  cannot  be  discerned  in  a natural 
state  to  have  more  than  one  coat,  and  that  exceed- 
ing thin,  having  valves  at  small  and  uncertain  dis- 
tances, to  prevent  the  regress  of  their  fluid.  They 
have  frequent  communications  like  the  veins,  but 
do  not  unite  so  often  ; the  larger  trunks  are  in  many 
places  attended  with  small  glands,  through  which 
they  run,  and  at  the  same  time  send  communicant 
branches  over  them,  that  they  might  be  secured 
against  obstructions  from  diseases  in  those  glands- 
They  all  terminate  in  the  vasa  lactea,  or  in  the  large 
veins.  All  that  rise  in  the  abdomen  empty  into  the 
venae  lacteae  secundi  generis  and  receptaculum  chyli ; 
those  in  the  cavity  of  the  thorax  into  the  ductus 
thoracicus  and  the  subclavian  veins.  Their  uses  are 
d d 


210 


LYMPH  A EDUCES. 


to  carry  lymph  to  dilute  the  chyle,  to  make  It  in- 
corporate more  readily  with  the  blood  (but  not  to 
make  it  flow  the  better  in  the  lacteals,  as  appears 
sufficiently  from  their  not  entering  into  the  minutest 
lacteals)  and  to  carry  off*  so  much  lymph  as  is 
necessary  to  leave  the  blood  in  fit  temper  to  flow 
through  the  veins  ; for  it  is  always  observed  that  in 
such  persons  as  have  their  blood  too  thin,  the  glo- 
buli  cohere  and  form  moleculae,  or  polypuses, 
which  I imagine  may  arise  from  the  globuli  of  the 
blood  not  rubbing  often  enough,  and  with  sufficient 
force  one  against  another  to  disunite  them  as  fast 
as  they  cohere.  These  polypuses  are  frequently 
found  in  all  the  large  veins,  and  in  the  right  au- 
ricle and  ventricle  of  the  heart,  especially  in  such 
bodies  as  die  hydropic  or  of  any  chronic  diseases. 

Authors  have  described  and  painted  these  ves- 
sels as  they  appear  when  injected  with  mercury  j 
in  which  case  the  coat  of  these  vessels  being  exceed- 
ing thin,  it  is  not  able  any  where  between  the  valves 
to  resist  the  mercury’s  attracting  itself  into  globules  : 
and  the  same  appearance  also  happens  when  they 
are  vastly  distended  ; because  the  valves  hindering 
a distention  where  they  are  seated,  the  spaces  be- 
tween them  approach  to  a spherical  figure  from  the 
equal  pressure  of  the  fluid,  according  to  the  degree 
of  their  distention  : but  in  a natural  state,  when 
they  are  filled  with  lymph,  or  when  they  are  mod- 
erately injected  with  air  or  water,  they  appear  as 
cylindrical  as  the  veins.  Any  of  these  vessels  being. 


ltmphaeducts. 


211 


burst,  they  cause  a dropsy  in  the  cavity  into  which 
they  open,  which  is  oftener  in  the  abdomen  than  the 
thorax.  This  kind  of  dropsy  is  sometimes  cured  by 
tapping,  and  I believe  the  reason  why  it  no  oftener 
succeeds  is,  that  it  generally  takes  its  rise  from  a dis- 
eased liver.  Formerly  in  this  operation  only  part  of 
the  water  was  drawn  off  at  a time,  and  the  tap  some- 
times left  in  the  wound  to  draw  off  more,  which 
was  exceeding  painful,  and  sometimes  brought  on 
a mortification  ; and  if  they  drew  off  much  water 
at  one  time  the  patient  was  in  great  pain,  and  gen- 
erally fainted,  which  was  thought  to  proceed  from 
the  loss  of  too  much  of  the  liquor  at  once.  But 
Dr.  Mead,  observing  that  these  symptoms  could  not 
proceed  from  the  loss  of  an  extravasated  fluid, 
soon  found  the  true  cause,  which  was  the  sudden 
want  of  the  pressure  of  the  abdominal  muscles 
against  the  parts  contained  in  the  abdomen  ; and 
in  the  year  1705,  being  then  physician  to  St, 
Thomas’s  hospital,  ordered  it  to  be  tried  there  in 
the  following  manner  : he  directed  the  abdomen 
to  be  pressed  by  the  hands  of  assistants  while  the 
water  was  running  out,  and  afterwards  kept  rolled 
till  the  muscles  recovered  force  to  do  their  office, 
and  so  took  out  all  the  water  at  once,  without  any 
inconvenience,  which  has  made  this  operation  not 
very  painful,  sometimes  successful,  and  never  dan- 
gerous. I preserved  one  woman,  by  sixteen  ope- 
rations, from  the  fifty  sixth  year  of  her  age  to  eigh- 
ty ; another  six  years  by  sixty  six  tappings ; it 


212 


LYMPHATIC  GLANDS. 


piust  be  confessed,  that  few  cases  succeed  like  these, 
and  very  few  recover. 

1 opened  a woman,  who  died  of  a dropsy  in 
the  liver,  in  which  I found  the  gibbous  part  en- 
tirely wasted,  and  the  coat  of  the  liver  about  a 
quarter  of  an  inch  thick,  which  contained  about 
five  gallons  of  a gross  yellowish  fluid,  in  which 
were  many  hydatids  about  the  size  of  gooseberries, 
and  some  pieces  of  matter  of  as  bright  a red  as  ver- 
milion. At  about  fourteen  years  of  age  she  first 
began  to  feel  pain  in  this  part,  which  returned 
monthly,  but  in  time  grew  continual,  her  belly 
constantly  increasing  till  she  died,  which  was  in 
the  twenty  eighth  year  of  her  age,  without  ever 
having  had  her  menses.  All  the  other  viscera  both 
fin  the  thorax  and  abdomen  were  perfectly  sound, 
nor  was  there  the  least  sign  of  the  dropsy  in  any 
of  the  limbs,  or  yellowness  in  the  skin,  which  is 
frequent  in  diseases  of  the  liver. 


CHAPTER  XI. 

OF  THE  LYMPHATIC  GLANDS. 

The  glands  accompanying  the  lymphatics 
are  situated  in  the  three  cavities,  in  the  inter- 
stices of  the  muscles,  where  the  lymphatics  lie  with 
the  large  blood  vessels,  and  in  the  four  emuncto- 
ries,  viz,  the  arm  pits  and  groins.  In  the  brain 


LYMPHATIC  CLANDS. 


213 


is  seated  the  glandula  pinealis,  which  I judge  to 
be  of  this  sort,  having  often  seen  large  lymphaeducts 
running  into  it  from  the  plexus  choroides  ; and  at 
the  basis  of  the  brain  in  the  cella  turcica  is  the  glan- 
dula pituitaria,  into  which  enters  a large  lymphatic, 
as  I imagine,  named  infundibulum  (vid.  chap.  Of 
the  brain.)  In  the  neck  are  situated  a great  many 
of  these,  by  the  sides  of  the  carotid  arteries  and  in- 
ternal jugular  veins,  and  two,  or  a sort  of  double 
one,  upon  the  larynx,  immediately  below  the  thy- 
roid cartilage,  from  which  situation  they  derive  the 
name  of  thyroidese  ; and  just  within  the  thorax  is 
seated  another,  called  thymus.  In  very  young  chil- 
dren the  thymus  is  as  large,  or  larger,  than  the  thy- 
roic  glands  ; but  in  men  these  glands  are  very  large, 
and  the  thymus  very  small,  the  former  having  in- 
creased in  about  a double  proportion  of  any  other 
gland  of  this  kind,  and  the  latter  having  rather  di- 
minished than  increased  ; but  in  brutes,  such  as 
have  fallen  under  my  observation,  it  is  just  the  con- 
trary. From  which  observations  I am  inclined  to 
conclude,  that  they  both  belong  to  the  very  same 
lymphatics,  and  that  either  of  them  increasing  as 
much  as  both  ought  to  do  if  both  increased,  an- 
swers the  same  end  as  if  both  did  ; and  that  the 
reason  why  the  thymus  increases  rather  than  the 
thyroid  glands  in  brutes,  is  because  the  shape  of 
their  thorax  affords  convenient  room  for  it  to  lodge 
in  ; and  that  in  men  the  thyroid  glands  increase 
so  much,  because  there  is  no  room  in  that  part  of 


214 


LYMPHATIC  GLANDS. 


the  thorax  where  the  thymus  is  seated  for  a large 
gland  to  be  lodged.  In  dogs,  a porpoise,  and  some 
other  animals,  I have  seen  the  lymphatics  in  the 
thymus,  and  between  the  thymus  and  ductus  tho- 
racicus,  full  of  chyle,  and  so  in  many  other  lym- 
phatics near  the  vasa  lactea.  Under  the  basis  of  the 
heart,  and  at  the  sides  of  the  lungs,  where  the  great 
vessels  enter,  are  many  of  these  glands,  from  the  size 
of  a pea  to  that  of  a hazel  nut.  In  the  abdomen, 
upon  the  loins,  near  the  kidneys,  and  by  the  sides  of 
the  iliac  vessels,  are  many  of  these  glands,  which  are 
called  lumbales  ; and  there  are  some  at  the  hollow 
side  of  the  liver  named  hepaticae  : the  mesentery 
also  is  full  of  glands  of  a like  appearance  ; but  these 
seem  to  belong  only  to  the  lacteal  veins,  unless  some 
of  them,  which  are  seated  at  the  basis  of  the  me- 
sentery, among  the  venae  lacteae  secundi  generis, 
belong  to  the  lymphatics  that  come  from  the  liver, 
where  the  hepatic  lymphatics  pass  in  their  way  to 
the  receptaculum  chyli.  The  glands  which  accom- 
pany the  blood  vessels  in  the  limbs  are  few,  and 
distributed  in  no  certain  order  ; except  those  in  the 
four  emunctories,  i.  e.  in  the  arm  pits  and  groins, 
named  axillares  and  inguinales. 

Brutes  have  one  laree  one  in  the  thigh,  com- 
monly  called  the  pope’s  eye  ; this  is  seated  about 
the  great  vessels  in  the  thigh,  where  they  pass 
through  the  triceps  muscle.  From  this  situa- 
tion, and  not  from  any  thing  extraordinary  in  this 
gland,  it  is  that  wounds  are  there  so  dangerous. 


LYMPHATIC  GLANDS. 


215 


The  lymphatic  glands  are  said  by  Nuck,  and 
others  after  him,  to  be  composed  of  vesicles,  and 
not  of  vessels  like  other  glands  ; and  that  these  ve- 
sicles are  repositories  of  lymph  : but  from  their 
appearance  in  a natural  state,  which  is  very  com- 
pact and  uniform,  there  seems  to  me  to  be  but  little 
reason  for  such  a conjecture.  Some  have  thought 
their  use  to  be  by  contracting  to  accelerate  the  mo- 
tion of  the  fluid  in  the  lymphatics  ; but  that  does 
not  seem  very  probable,  because  a muscular  coat 
would  have  been  the  readiest  means  to  produce  that 
effect  ; besides,  those  vessels  seldom  enter  any  of 
them  without  detaching  a branch  over  at  the  same 
time,  perhaps  to  prevent  obstructions.  And  if  these 
glands  were  endued  with  a contracting  power,  which 
is  only  presumed  without  any  proof,  it  would  still 
be  difficult  to  conceive  how  such  a power,  applied 
at  uncertain  spaces,  should  not  rather  obstruct  than 
accelerate  the  motion  of  lymph  in  the  lymphatics, 
unless  there  were  valves  to  prevent  a reflux  ; and 
even  then,  if  this  were  a convenient  piece  of  me- 
chanism, it  would  be  strange  it  should  no  where  else 
in  the  body  be  made  use  of. 

These  lymphatic  glands  being  diseased,  are  apt 
to  obstruct  and  occasion  the  bursting  of  the  lym- 
phatics that  pass  through  them  ; which,  if  in  the 
breast,  causes  an  incurable  hydrops  pectoris  ; if  in 
the  abdomen,  the  true  ascites,  attended  with  a wast- 
ing of  the  limbs,,  which  is  never  cured,  but  may  be 
relieved  by  tapping. 


216 


COURSE  OF  THE 


CHAPTER  XII. 

OF  THE  COURSE  OF  THE  ALIMENT  AND  FLU- 
IDS, ABSTRACTED  FROM  THE  FOREGOING  CHAP- 
TERS. 

Teie  aliment  being  received  into  the  mouth,  is 
there  masticated,  and  impregnated  with  saliva, 
which  is  pressed  out  of  the  salivary  glands  by 
the  motions  of  the  jaw  and  the  muscles  that  move 
it  and  the  tongue.  Then  it  descends  through  the 
pharynx  into  the  stomach,  where  it  is  digested  by 
the  juices  of  the  stomach  (which  are  what  is 
thrown  out  of  the  glands  of  its  inmost  coat,  and 
saliva  out  of  the  mouth)  and  a moderate  warmth 
and  attrition.  Then  it  is  thrown  through  the  py- 
lorus or  right  orifice  of  the  stomach  into  the  duo- 
denum, where  it  is  mixed  with  bile  from  the  gall- 
bladder and  liver,  and  the  pancreatic  juice  from 
the  pancreatic  gland.  These  fluids  serve  farther  to 
attenuate  and  dilute  the  digested  aliment,  and  prob- 
ably to  make  the  fluid  part  separate  better  from 
the  feces.  After  this  it  is  continually  moved  by 
the  peristaltic  motion  of  the  guts,  and  the  com- 
pression of  the  diaphragm  and  abdominal  muscles, 
by  which  forces  the  fluid  parts  are  pressed  into  the 
lacteals,  and  the  gross  parts  through  the  guts  to  the 
anus. 

The  chyle,  or  thin  and  milky  part  of  the  ali- 
ment, being  received  into  the  lacteals  from  all  the 


ALIMENT  AND  ELUID3.  217 

small  guts,  they  carry  it  into  the  receptaculum  chy- 
li,  and  from  thence  the  ductus  thoracicus  carries  it 
into  the  left  subclavian  vein,  where  it  mixes  with 
the  blood,  and  passes  with  it  to  the  heart. 

All  the  veins  being  emptied  into  two  branches, 
viz.  the  ascending  and  descending  cava,  they  empty 
into  the  right  auricle  of  the  heart  ; the  right  auri- 
cle unloads  into  the  right  ventricle,  which  throws 
the  blood  through  the  pulmonary  artery  into  the 
lungs  ; from  the  lungs  the  blood  is  brought  by  the 
pulmonary  veins  into  the  left  auricle,  and  from 
that  into  the  left  ventricle,  by  which  it  is  thrown 
into  the  aorta,  and  distributed  through  the  body. 
From  the  extremities  of  the  arteries  arise  the  veins 
and  lymphatics  ; the  veins  to  collect  the  blood  and 
bring  it  back  to  the  heart ; and  the  lymphatics  to 
return  the  lymph,  or  thinner  part  of  the  blood,  from 
the  arteries  to  the  veins  and  the  vasa  lactea,  where  it 
mixes  with  the  chyle,  and  then  passes  with  it  into 
the  left  subclavian  vein  and  to  the  heart. 

All  the  fluids  that  pass  into  the  stomach  and 
guts  being  carried  into  the  blood  vessels,  the  great- 
est part  of  them  are  separated  and  carried  off  by- 
proper  vessels,  viz.  urine  from  the  kidneys,  bile 
from  the  liver,  &c.  and  these  juices  carry  along 
with  them  whatever  might  be  injurious  to  the 
animal  economy. 


218  DUKA  MATEJU 

CHAPTER  XIII. 

OF  THE  DURA  MATER  AND  PIA  MATER. 

D URA  mater  is  a very  compact,  strong  mem- 
brane, lining  the  inside  of  the  scull,  firmly  ad- 
hering at  its  basis,  and  but  lightly  at  the  upper 
part,  except  at  the  sutures.  It  has  three  processes  ; 
the  first,  named  falx,  begins  at  the  crista  galli, 
and  runs  backwards  under  the  suture  sagittalis  to 
the  cerebellum,  dividing  the  cerebrum  into  two 
hemispheres.  Its  use  is  said  to  be  to  support  one 
side  of  the  cerebrum  from  pressing  on  the  other 
when  the  head  is  inclined  to  one  side.  But  I 
think  it  is  evident  that  this  is  not  the  use,  because 
there  would  be  more  need  of  such  a process  from 
one  side  of  the  scull  to  the  other,  than  this  way  ; 
and  it  would  also  be  very  necessary  that  it  should 
run  through  the  brain,  to  answer  that  end.  The 
principal  use  appears  to  me  to  be,  to  divide  the  brain 
into  such  portions  as  are  least  liable  to  be  moved 
in  the  scull,  by  any  violent  motions  of  the  head, 
which  is  better  done  this  way  than  it  would  the 
other  ; and  the  under  side  of  the  brain  is  kept  steady 
by  the  inequalities  of  the  basis  of  the  scull,  which 
the  brain  is  exactly  fitted  to.  In  brutes  the  falx 
is  always  very  small,  therefore  in  those  whose 
brains  are  of  the  larger  size,  as  oxen;  sheep,  horses, 
&c.  the  upper  part  of  the  scull  is  made  uneven, 
exactly  to  fit  the  folds  of  the  brain  which  secures- 


BUR  A MATER, 


219 


the  upper  parts  of  their  brains  from  concussions,  in 
.the  same  manner  that  the  lower  parts  are  secured. 
The  second  process  runs  from  the  lower  and  back 
part  of  the  former  to  the  upper  edge  of  each  os 
petrosum,  and  sustains  the  posterior  lobes  of  the 
cerebrum,  that  they  might  not  compress  the  cere- 
bellum. In  such  rapacious  animals  as  I have  dis- 
sected, this  process  is  bone.  The  third  is  very 
small ; it  runs  from  the  last  described  process  down 
towards, the  great  foramen  of  the  scull,  and  possesses 
the  small  space  in  the  cerebellum,  between  the  pro- 
cessus vermiformisc  These  processes  of  the  dura 
mater  also  serve  to  keep  the  brain  steady. 

The  dura  mater  has  in  it  several  sinuses,  which 
are  large  veins  to  receive  the  blood  from  the  lesser 
veins  of  the  brain  : their  number  is  uncertain,  and 
those  that  are  constant  are  not  described  in  the 
same  order  by  writers.  The  first  that  presents  itself 
is  the  longitudinalis  superior,  running  from  a blind 
hole  a little  above  the  crista  galli  all  along  the 
upper  edge  of  the  falx.  A transverse  section  of 
this  vessel  is  not  circular,  like  other  vessels,  but  a 
triangle,  whose  sides  are  arches  of  a circle  ; the 
upper  side  convex  outwards,  and  the  two  lower 
convex  inwards.  The  figure  of  this  vessel  is  pre- 
served by  small  ligaments  running  across  in  the  in- 
side, that  it  might  not  become  conical,  or  cylindri- 
cal, like  other  vessels,  from  the  equal  pressure  of 
the  contained  blood,  and  thereby  incommode  the 
upper  edges  of  each  hemisphere  of  the  cerebruigu 


220 


DURA  MATER. 


On  the  lower  edge  of  this  process  is  generally  an* 
other  very  small  one,  called  longitudinal! s inferior  ; 
this  runs  into  the  rectus,  and  when  wanting  is 
supplied  by  a vein  ; the  rectus  runs  between  the  two 
first  processes  of  the  dura  mater,  and  unloads  with 
the  sinus  longitudinalis  superior  into  the  two  later- 
al sinuses  ; but  for  the  most  part  the  longitudinal 
sinus  goes  more  directly  into  one  of  the  lateral  si- 
nuses, and  the  straight  sinus  into  the  other.  There 
is  sometimes  a small  one  in  the  third  process,  which 
empties  in  the  same  place  with  the  former.  From 
the  endings  of  the  longitudinal  and  aight  sinuses, 
begin  the  two  lateral  sinuses,  which,  when  they 
come  to  the  os  petrosum,  dip  down  and  pass  through 
the  eighth  foramina  into  the  internal  jugular  veins. 
There  is  another  named  circularis  ; it  runs  round 
the  fore  part  only  of  the  cella  turcica  ; the  two 
ends  of  this  empty  into  four  sinuses,  one  on  the 
top  of  each  os  petrosum,  which  pass  into  the  sinus 
lateralis,  and  one  at  the  under  sides  of  the  same 
bones,  which  pass  indifferently  into  both  the  late- 
ral and  cervical  sinuses  ; these  two  last  sinuses  have 
always  communicant  branches.  The  cervical  si- 
nuses run  from  the  basis  of  the  scull  through  the 
great  foramen  on  both  sides  of  the  medulla  spi- 
nalis colli,  and  through  the  transverse  processes  of 
the  cervical  vertebrae  ; the  last  of  these  have  many 
times  proper  foramina  running  from  the  eighth 
foramina  to  the  back  part  of  the  apophyses  of  the 
occipital  bone.  There  are  also  two  more  of  these 


PIA  MATER. 


221 


vessels,  which  run  from  the  circular  sinus  between 
the  os  sphenoides  and  fore  part  of  the  os  petro- 
sum  directly  into  the  internal  jugular  veins. 

Pia  mater  is  an  exceeding  fine  membrane  im- 
mediately investing  the  brain,  even  between  its 
lobes,  hemispheres,  and  folds.  It  serves  to  contain 
the  brain,  and  support  its  blood  vessels,  which  run 
here  in  great  numbers,  for  the  arteries  to  divide 
into  small  branches  upon,  that  the  blood  may  not 
enter  the  brain  too  impetuously  : and  for  the  veins 
to  unite  on,  that  they  may  enter  the  sinuses  in 
fewer  and  larger  branches.  Between  the  dura 
and  pia  mater,  is  described,  by  several  anatomists, 
a membrane  called  arachnoides,  which  may  easily 
be  shewn  at  the  back  part  of  the  cerebrum,  upon 
the  cerebellum  and  back  part  'of  the  medulla 
spinalis. 

I have  seen  a large  part  of  the  dura  mater,  and 
once  part  of  the  pia  mater  ossified. 


CEREBRUM. 


CHAPTER  XIV. 

OF  THE  CEREBRUM,  CEREBELLUM,  MEDULLA  OB- 
LONGATA, AND  MEDULLA  SPINALIS. 

Cerebrum  is  that  part  of  the  brain  which 
possesses  all  the  upper  and  fore  part  of  the 
cranium,  being  separated  from  the  cerebellum 
by  the  second  process  of  the  dura  mater.  Its 
upper  side  is  divided  into  two  hemispheres,  and  its 
lower  side  into  four  lobes,  two  anterior  and  two 
posterior,  which  latter  are  much  the  largest.  At 
the  meeting  of  the  four  lobes  appears  the  infundi- 
bulum, which  seems  to  be  a lymphatic,  running 
from  the  ventricles  of  the  brain  into  the  glandula 
pituitaria  : this  gland  is  seated  in  the  cella  turcica. 
Immediately  behind  the  infundibulum  appear  two 
small  bodies,  named  protuberantise  duae  albae  pone 
infundibulum.  Between  the  two  hemispheres  of 
the  cerebrum,  lower  than  the  circumvolutions, 
appears  a white  body  named  corpus  callosum. 
Under  the  corpus  callosum  appear  the  two  lateral 
or  superior  ventricles,  which  are  divided  into  right 
and  left  by  a very  thin  membrane,  named  septum 
lucidum,  which  is  extended  between  the  corpus 
callosum  and  fornix.  The  fornix  is  a medulla- 
ry body  beginning  from  the  fore  part  of  thes,e 
ventricles,  with  two  small  roots  which  soon  unite  ; 
and  running  towards  the  back  part,  where  they 
divide  into  parts,  called  crura  fornicis.  In  the 


CEREBELLUM. 


223 


basis  of  these  two  ventricles  are  four  prominences  : 
The  two  anterior  are  called  (from  their  inner  tex» 
ture)  corpora  striata  ; the  other  two  are  named 
thalami  nervorum  opticorum.  Beyond  these  are 
two  more  processes,  called  nates  ; and  under  them, 
nearer  the  cerebellum,  two  called  testes.  Above 
the  nates  is  situated  the  glandula  pinealis,  famous 
for  being  supposed  by  Des  Cartes,  the  seat  of 
the  soul.  And  upon  the  thalami  nervorum  opti- 
corum are  a number  of  blood  vessels,  glands,  and 
lymphseducts,  called  plexus  choroides.  Under  the 
beginning  of  the  fornix  is  a small  hole,  called  fo- 
ramen ad  radices  fornices,  or  iter  ad  infundibulum ; 
and  under  the  middle  of  the  fornix,  one  called  fo- 
ramen posterius,  which  is  covered  with  a valve 
named  membrana,  or  valvula  major  ; and  the  space 
I under  the  two  anterior  ventricles  between  the  for- 
amina and  the  cerebellum  is  the  third  ventricle. 

Cerebellum  is  situated  under  the  second  process 
of  the  dura  mater.  By  dividing  this  part  of  the 
brain  lengthways  we  discover  more  plainly  the 
fourth  ventricle,  whose  extremity  is  called  calamus 
scriptorius  ; here  also  appear  two  medullary  bod- 
ies called  pedunculi,  which  are  the  basis  of  the 
cerebellum.  The  medullary  part  in  the  cerebellum, 
though  it  is  inmost,  as  in  the  cerebrum,  yet  is  of  a 
different  shape,  being  branched  out  like  a plant. 

The  substance  of  the  brain  is  distinguished  into 
outer  and  inner  : the  former  is  called  corticalis,  ci- 
nerea,  or  glandulosa  ; the  latter  medullaris,  alba,  or 


nervea. 


224  MEDULLA  OBLONGATA^  &X. 

Medulla  oblongata  is  a medullary  continuation 
of  the  under  part  of  the  cerebrum  and  cerebellum * 
It  first  appears  in  two  bodies  from  the  anterior 
part  of  the  posterior  lobes  of  the  cerebrum,  call- 
ed crura  medulla  oblcngatae.  The  union  of  these 
crura  between  the  cerebrum  and  cerebellum  is 
called  isthmus  ; and  immediately  beyond  this  is 
an  eminence  named  processus  annularis. 

Medulla  spinalis  is  a production  of  the  medulla 
oblongata  through  the  great  foramen  of  the  scull, 
and  through  the  channel  of  the  spine  : it  enlarg- 
es about  the  last  vertebrae  of  the  back  and  first  of 
the  neck,  where  the  large  nerves  are  given  off  to 
the  arms  : it  again  enlarges  in  the  loins,  where  the 
crural  nerves  begin  ; and  the  lower  end  of  it,  with 
those  and  other  nerves,  is  called  from  its  resem- 
blance cauda  equina.  The  coats  of  this  part  are 
the  same  with  those  of  the  brain  ; but  the  mem- 
brane here,  which  is  analogous  to  the  dura  mater, 
is  thinner  and  more  connected  to  the  bones,  and 
the  tunica  arachnoides  more  conspicuous. 

Wounds  in  the  cerebrum,  though  very  danger- 
ous, are  not  mortal  ; but  in  the  cerebellum  and 
medulla  oblongata  cause  sudden  death  ; and  in  the 
medulla  spinalis,  loss  of  sense  in  all  the  parts  which 
receive  nerves  from  below  the  wound.  In  persons 
that  have  died  lethargic,  I have  always  found  the 
brain  full  of  water  : and  in  children,  the  brain  is 
always  very  soft  and  moist.  In  a man,  that  died 
of  an  apoplexy,  I found  all  the  vessels  of  the  brain 


NERVES. 


225 


immoderately  distended  with  blood,  and  the  ventri- 
cles and  the  substance  of  the  brain  full  of  lymph, 
the  pia  mater  very  much  thickened,  and  adhering 
so  very  loosely  that  the  greatest  part  of  it  was 
separated  without  breaking. 

I have  twice  seen  in  the  cerebrum  a scirrhous 
tumor  as  large  as  a pullet’s  egg  ; and  in  another 
body,  imposthumations  which  possessed  near  two 
thirds  of  the  whole  cerebrum.  And  in  a person 
that  died  with  a gutta  serena,  I found  all  the  ven- 
tricles of  the  brain  full  of  lymph  ; and  the  tha- 
lami  nervorum  opticorum  and  the  optic  nerves,  ere 
they  went  out  of  the  scull,  made  flat  with  the  pres- 
sure. And  in  an  old  man  I found  the  right  optic 
nerve  wasted  and  black. 


CHAPTER  XV. 

OF  THE  NERVES. 

“ F ROM  the  medullary  part  of  the  cerebrum, 
“ cerebellum,  and  medulla  spinalis,  a vast  num- 
“ ber  of  small  medullary  white  fibres  are  sent 
“ out,  which,  at  their  first  egress,  seem  easily  to 
“ separate,  but  as  they  pass  forward  are  somewhat 
“ more,  but  still  loosely  connected,  by  the  coat 
“ which  they  obtain  from  the  pia  mater,  and  at 
“ last  piercing  the  dura  mater,  are  straitly  braced 
“ by  that  membrane  which  covers  them  in  their 

“ progress  ; whence  they  become  white,  firm, 
E f 


226 


NERVES. 


44  strong  cords,  and  so,  are  well  known  by  the 
44  name  of  nerves.  To  these  coats  an  infinite  num- 
44  ber  of  vessels,  both  arteries  and  veins,  are  dis- 
44  tributed  ; so  that  after  a nice  lucky  injection  the 
44  whole  cord  is  tinged  with  the  colour  of  the  in- 
44  jected  liquor  : but  when  the  fibrils  are  examined, 
44  even  with  the  best  microscope,  they  appear  only 
44  like  so  many  small  distinct  threads  running  pa- 
44  rallel,  without  any  cavity  observable  in  them, 
“ though  some  incautious  observers,  mistaking  the 
44  cut  orifices  of  the  arterious  and  venous  vessels, 
44  just  now  mentioned,  for  nervous  tubes,  have  af- 
44  firmed  their  cavities  to  be  visible.  The  nerves, 
44  which  if  all  joined  hardly  make  a cord  of  an  inch 
44  diameter,  would  seem,  from  their  exerting  them- 
44  selves  everywhere,  to  be  distributed  to  each,  even 
44  the  smallest  part  of  the  body.  In  their  course 
44  to  the  places  for  which  they  are  destined,  they 
44  generally  run  as  straight  as  the  part  over  which 
44  they  are  to  pass,  and  their  own  safety  from  exter- 
44  nal  injuries,  will  allow,  sending  off  their  branch- 
“ es  at  very  acute  angles,  and  consequently  run- 
44  ning  more  parallel  than  the  blood  vessels.  Their 
44  distribution  is  seldom  different  in  the  opposite 
44  sides  of  the  same  subject,  nor  indeed  in  any 
44  two  subjects  is  there  considerable  variety  found. 
44  Frequently  nerves  which  come  out  distinct  or 
44  separate,  afterwards  conjoin  into  one  fasciculus, 
44  under  the  same  common  covering  ; and  though 
44  the  nervous  fibrils  probably  do  not  communicate 


NERVES. 


22 1 


44  (the  reason  of  which  opinion  shall  immediately 
“ be  given)  yet  because  the  coats  at  the  conjoined 
44  part  are  common,  and  these  strong  coats  may 
44  have  great  effects  on  the  soft  pulpy  nerves,  it  is 
44  evident  all  such  will  have  a considerable  sympa- 
44  thy  with  one  another,  v/hereof  several  exam- 
44  pies  in  practice  shall  be  instanced  when  the  par- 
44  ticular  nerves  are  described.  In  some  parts 
44  where  there  are  such  conjunctions,  the  bulk  of 
44  the  nerves  seems  much  increased,  and  these 
44  knotty  oval  bodies,  called  by  Fallopius  cor- 
44  pora  olivaria,  and  generally  now  named  gang- 
44  lions,  are  formed.  The  coats  of  these  knots 
44  are  stronger,  thicker,  and  more  muscular  than 
44  the  whole  nerves  which  enter  into  them  would 
44  seem  to  constitute,  while  the  nervous  fibrils 
44  pass  through  without  any  great  alteration  or 
44  change.  I do  not  think  any  author  has  yet 
44  made  a probable  conjecture  of  the  use  or  design 
44  of  these  ganglions,  whether  they  imagine  them 
44  corcula  expellentia,  reservoirs,  or  elaboratories, 
44  neither  can  I give  an  account  of  their  use  the 
44  least  satisfactory  to  myself. 

44  From  undeniable  evident  experiments,  all  an- 
44  atomists  are  now  convinced  that  to  the  nerves 
44  we  owe  all  our  sensation  and  motion,  of  which 
44  they  are  the  proper  organs  ; and  the  sensations 
44  in  the  minutest  parts  being  very  distinct,  there- 
<4  fore  the  instruments  of  such  sensations  must  have 
distinct  origins  and  course  to  each  part.  Though 


228 


NERVES. 


44  all  are  agreed  as  to  the  effect,  yet  a hot  dispute 
44  has  arisen  about  the  manner  how  it  is  produced, 
44  viz.  whether  sensation  and  motion  are  occasioned 
“ by  a vibration  communicated  to  the  nerves,  which 
44  these  gentlemen  suppose  entirely  solid  and  tense, 
44  or  by  a liquid  contained  and  moved  in  them. 
44  The  last  of  these  opinions  I rather  incline  to,  for 
“ these  reasons,  because  the  nerves  proceeding  from 
44  the  brain  bear  a great  analogy  to  the  .excretory 
44  ducts  of  other  glands.  Then  they  are  far  from 
44  being  stretched  and  tense  in  order  to  vibrate. 
44  And  what  brings  the  existence  of  a liquid  in  their 
44  cavities  next  to  a demonstration  is  the  experiment 
44  first  made  by  Bellini,  and  related  by  Bohn 
44  and  Pitcairn,  which  I have  often  done  with 
44  exact  good  success  ; it  is  this  : After  opening  the 
44  thorax  of  a living  dog,  catch  hold  of  and  compress 
44  the  phrenic  nerve,  immediately  the  diaphragm 
44  ceases  to  act ; remove  the  compressing  force,  that 
44  muscle  again  contracts  ; gripe  the  nerve  with  one 
££  hand  some  way  above  the  diaphragm,  that  sep- 
“ turn  is  unactive  ; then  with  the  other  hand  strip 
44  clown  the  nerve  from  the  first  hand  to  the  dia~ 
£C  phragm,  this  muscle  again  contracts  ; after  once 
44  or  twice  having  stripped  the  nerve  thus  down 
44  or  exhausted  the  liquid  contained  in  it,  the  mus- 
44  cle  no  more  acts,  squeeze  as  you  will,  till  the 
44  first  hand  is  taken  away  or  removed  higher,  and 
44  the  nerve  stripped,  i.  e.  the  liquids  in  the  supc- 
rior  part  of  the  nerve  have  free  access  to  the  dia- 


NERVES. 


229 


« phragm,  or  are  forced  down  to  it,  when  it  again 
t(  will  move.  Now  if  this  liquid  should  be  granted 
“us,  I am  afraid  we  shall  be  still  as  much  at  a 
“ loss  to  account  for  sensation  and  motion  as  ever  ; 
“ and  therefore  all  I shall  assume  is  what  is  found- 
“ ed  on  experiments,  that  these  two  actions  do  de- 
“ pend  on  the  nerves ; that  sensations  are  pleasant 
“ as  long  as  the  nerves  are  only  gently  affected 
C£  without  any  violence  offered  them  ; but  as  soon 
“ as  any  force  applied  goes  beyond  this,  and 
“ threatens  a solution  of  union,  it  creates  that 
“ uneasy  sensation,  pain  : the  nerves,  their  source 
“ or  their  coats  being  vitiated,  either  convulsion  or 
<e  palsy  of  the  muscles  may  ensue. 

“ The  nerves  are  distinguished  into  two  classes, 
“ of  the  encephalon  and  medulla  spinalis  ; of  the 
<£  first  there  are  generally  ten  pair  reckoned,  of 
“ the  last  thirty.  I shall  describe  the  nerves  in 
“ the  same  order  in  which  they  are  generally 
“ ranked,  though  it  is  not  possible  to  prosecute  the 
“ dissection  of  them  after  the  same  manner  ; but 
“ to  supply  this,  I shall  mention  also  the  order 
“ wherein  they  may  be  all  demonstrated  on  one 
“ subject.  When  I assign  the  origin  of  any  nerve 
“ from  any  particular  part,  I desire  it  may  be  un- 
u derstood  of  that  part  of  the  surface  of  the  me- 
“ dulla,  where  the  nerve  first  appears  ; for  by  this 
“ method  we  shall  shun  any  dispute  with  those  au- 
“ thors  who  trace  their  rise  too  minutely,  and  per- 
haps  be  less  liable  to  mistake  or  to  deceive  our 


230 


NERVES. 


44  readers.  Nor  shall  I be  over  anxious  about  the 
44  terminations  of  the  minima;  fibrillre,  since  it  is 
44  not  possible  to  trace  them  ad  ultimos  fines,  nor 
44  do  I think  it  very  necessary  for  explaining  any 
44  phaenomena,  while  very  often  in  a multiplicity  of 
44  words  the  whole  description  comes  to  be  obscure 
cc  or  unintelligible. 

o 

44  Of  the  ten  pair  proceeding  from  the  encepha- 
44  Ion,  the  first  is  the  olfactory,  which  in  brutes, 
44  justly  enough,  has  the  name  of  processus  ma- 
44  millares  bestowed  on  them,  being  large  and  hol- 
44  low,  and  are  indeed  evidently  the  two  anterior 
44  ventricles  of  the  brain  produced  ; which  structure 
44  and  the  lymph  constantly  found  in  them,  induced 
44  the  ancients  to  believe  that  they  served  as  emunc- 
44  tories  to  convey  the  superabundant  mucus  from 
44  the  cold  moist  brain  to  the  nose ; but  in  man 
44  they  are  small,  long,  and  without  any  cavity, 
44  rising  from  that  part  of  the  brain  where  the  ca- 
44  rotid  arteries  are  about  to  enter,  and  running  un- 
44  der  the  anterior  lobes  of  the  brain  become  a little 
44  larger,  till  they  reach  the  os  tribriforme,  into 
44  the  foramina  of  which  the  small  filaments  in- 
44  sinuate  themselves,  as  upon  gently  pulling  those 
44  nerves,  or  after  having  cut  them  very  near  the 
44  bone,  is  evident,  and  are  immediately  spread  on 
44  the  membrana  narium.  Their  tender  structure 
44  and  sudden  expansion  on  such  a large  surface, 
44  make  it  impossible  to  trace  them  on  the  mem- 
44  brane  of  the  nostrils,  which  has  given  some  handle 


NERVES. 


231 


44  to  several  authors  to  deny  them  the  structure  or 
44  use  of  nerves. 

“ The  second  are  the  optic,  which  arise  single 
44  from  the  thalami  nervorum  opticorum,  and  then 
44  uniting  at  the  fore  part  of  the  cella  turcica,  they 
44  seem  to  be  pretty  much  blended  ; afterwards  they 
44  divide,  and  running  obliquely  forwards,  pass  out 
44  at  their  proper  hole  of  the  sphenoide  bone,  and 
44  enter  the  globe  of  the  eye  to  be  expanded  into 
44  the  membrana  retina.  From  this  conjunction  of 
44  these  nerves,  authors  generally  endeavour  to  ac- 
44  count  for  our  seeing  objects  single,  whereas  we 
44  have  reason  to  believe  fishes,  the  chamseleon,  &c. 
44  whose  optic  nerves  simply  cross  one  another  with- 
44  out  any  such  union,  do  see  objects  also  single, 
44  since  they  so  exactly  rush  on  their  prey  ; where- 
44  as  if  those  authors’  assertions  were  true,  they 
44  would  oftener  catch  at  the  shadow  than  the  sub- 
44  stance.  The  blood  vessels  running  through  the 
44  middle  of  these  nerves,  and  the  ramifications  of 
44  the  retina  are  very  observable,  whence  we  may 
44  deduce  the  reason  of  Picard’s  experiment  of 
44  such  objects  as  fall  on  the  entry  of  the  optic  nerve 
44  being  lost  to  us  ; and  hence  also  an  account  may 
44  be  given  of  an  amaurosis  or  gutta  serena. 

44  The  third  pair  of  nerves  first  appear  at  the 
44  anterior  part  of  the  processus  annularis,  and  go- 
44  ingout  at  the  foramen  lacerum,  are  distributed  to 
44  the  globe  of  the  eye  ; musculus  rectus  Fallopii, 
44  attolens,  adducens,  deprimens,  and  obliquus  mi- 


232 


NERVES. 


“ nor  ; therefore  this  pair  has  justly  got  the  name 
“ of  motores  oculi. 

“ The  fourth  pair,  which  are  the  smallest  of 
“ any,  derive  their  origins  from  the  anterior  lateral 
“ part  of  the  processus  annularis,  and  go  out  at  the 
“ foramina  lacera  to  be  entirely  spent  on  the  mus* 
“ culi  trochleares,  or  obliqui  majores  oculorum, 
“ to  which  muscles  chiefly  the  rotatory  motion  of 
“ the  eyes  in  ogling,  and  the  advance  of  the  eyes 
“ forward  in  staring  and  fury,  is  owing  ; for 
44  which  reason  anatomists  have  called  these  nerves 
44  pathetici. 

44  The  fifth  pair  arise  from  the  sides  of  the  an- 
44  nular  process,  and  after  piercing  the  dura  mater 
44  divide  into  three  branches  ; the  first  of  which  is 
44  the  ophthalmic,  which  as  it  is  about  to  enter 
44  the  orbit  by  the  foramen  lacerum,  sends  off  a 
44  small  twig  that  assists  in  the  formation  of  the 
44  intercostal,  and  then  the  nerve  is  distributed  to 
“ the  glandula  lacrymalis,  fat  membranes,  and  pal- 
44  pebrse  of  the  eye,  while  it  sends  one  considerable 
44  branch  through  the  orbiter  internus  anterior  hole 
^4  to  be  lost  in  the  membrana  narium,  and  a second 
44  passes  the  foramen  and  supercilia  to  supply  the 
44  muscles  and  teguments  of  the  forehead.  Hence 
44  we  easily  discover  what  part  is  affected  in  that 
44  painful  disease  the  megrim,  when  the  eyeball 
44  and  forehead  are  racked,  and  such  a heat  is  felt 
44  within  the  nose.  Hence  also  we  may  learn  how 
44  the  muscles  of  respiration  come  to  be  so  much 


NERVES* 


233 


f£  affected  on  the  application  of  any  acrid  irritating 
*4  substance  to  the  membrana  narium,  as  to  pro* 
*c  duce  that  violent  convulsive  motion,  sneezing, 
“ The  second  branch  of  the  fifth  pair,  which  may 
s‘  be  called  maxillaris  superior,  passes  out  through 
“ the  foramen  rotundum  ossis  sphenoidis,  and  im« 
“ mediately  gives  nerves  to  the  fat  under  the  cro« 
cc  taphite  muscle,  and  to  the  palate,  sinus  sphenoi- 
“ dalis,  and  nostrils.  The  remaining  trunk  insinu- 
“ ating  itself  into  the  channel  on  the  top  of  the 
“ antrum  Higlnnorianum,  to  which  cavity  and  to 
c<  the  teeth  of  the  upper  jaw  it  gives  small  twigs, 
“ at  last  comes  out  at  the  orbiter  externus  hole, 
u and  is  spent  on  the  musculus  orbicularis  palpebra- 
“ rum,  nose,  and  upper  lip,  where  some  branches 
“ of  the  seventh  pair  seem  to  unite  themselves  to 
s‘  the  twigs  of  this.  The  third  branch,  or  maxil- 
“ laris  inferior,  goes  out  at  the  foramen  ovale,  or 
“ fourth  hole  of  the  wedge-like  bone,  and  soon 
“ splitting  into  a great  many  branches,  is  distrib- 
“ uted  to  the  musculus  crotaphites,  masseter,  pte- 
<c  rygoides,  digastricus,  buccinator,  mylohyoideus, 
“ geniohyoideus,  genio-glossus,  and  basio-glossus, 
“ glandula  sublingualis,  maxillaris  inferior,  and  pa- 
“ rods,  to  the  external  ear,  where  it  seems  to  join 
“ the  pordo  dura  to  the  substance  of  the  tongue, 
“ in  which  it  is  pretty  much  confounded  with  the 
C{  ninth  pair  : from  the  root  of  this  last  branch  the 
“ chorda  tympani  is  reflected.  The  last  ramifica- 
“ tion  oT  this  branch  which  I shall  mention,  is 
0 g 


234 


SERVES. 


44  that  which  enters  into  the  canal  of  the  lower  jaw 
“ furnishes  the  teeth  there,  and  comes  out  at  the 
“ chin,  on  which  and  the  lower  lip  it  is  bestowed  ; 
“ at  this  place  it  is  again  conjoined  to  the  seventh 
44  pair.  From  this  short  sketch  of  the  large  fifth 
“ pair  of  nerves,  and  by  observing  several  phaenom- 
“ ena  which  happen  to  those  parts  to  which  they 
44  are  distributed,  we  might  have  a much  farther 
44  confirmation  of  the  general  doctrine  of  nerves 
44  delivered,  and  see,  at  least,  the  way  pathed  to  a 
44  rational  account  of  these  phenomena,  for  reason- 
44  ing  on  which  we  should  not  otherwise  have  the 
44  least  ground.  We  can,  for  example,  from  the 
44  chorda  tympani  and  the  nerves  of  the  teeth,  bc- 
44  ing  derived  from  the  same  common  trunk,  un- 
44  derstand  how  the  sound  of  any  vibrating  body 
64  held  between  our  teeth  is  sensible  to  us,  when 
44  another  cannot  possibly  hear  the  least  of  it.  By 
44  the  like  rule  we  know  why  in  a violent  tooth- 
44  ache  the  muscles  of  the  face  are  sometimes  con- 
44  vulsed  ; nor  shall  we  be  surprised  to  hear  one 
44  plagued  with  the  ache  in  his  upper  teeth,  com- 
44  plain  of  a gnawing  pain  deep  seated  in  the  bones 
44  of  his  face,  or  to  see  his  eyelids  much  swelled, 
“ or  the  tears  trickling  down  in  great  abundance ; 
44  whereas  the  lower  teeth  aching,  the  ear  is  pain- 
“ ed,  and  the  saliva  flows  in  great  quantities.  We 
<c  may  have  some  distant  views  of  some  foundation 
44  in  reason  for  the  cure  of  the  toothache,  by  strong 
44  compression  of  the  chin,  or  by  applying  blisters. 


N-LRVES. 


23  S 


**  behind  the  ears,  or  by  burning  behind  or  on  the 
“ ear.  Among  a great  many  instances  of  the  good 
“ effect  of  the  actual  cautery  in  such  a case,  I shall 
“ give  one  which  seems  to  be  remarkable  : I.  M. 
“ was  seized  with  the  toothache,  a convulsion  of 
“ that  whole  side  of  his  face  followed  whenever 
“ the  pain  became  acute,  or  he  attempted  to 
<s  speak ; after  he  had  undergone  bleeding,  purg- 
^ ing,  salivation,  setons,  &c.  without  any  benefit, 
<c  he  was  cured  by  applying  a small  cauterising 
“ iron  to  the  antihelix. 

“ The  sixth  pair  of  n-erves  arising  from  the  fore 
<c  part  of  the  corpora  pyramidalia,  after  piercing 
“ through  the  dura  mater,  give  off  a branch, 
ei  which,  joined  with  the  reflected  twig  of  the  oph- 
“ thalmic  branch  of  the  fifth  pair,  forms  the  origi- 
“ nal  of  the  intercostal,  passes  through  the  fora- 
“ men  lacerum  to  be  spent  entirely  on  the  mus- 
tc  cuius  abductor  oculi  : supposing  this  nerve  to 
<c  supply  ever  so  little  less  than  a due  proportion 
*c  of  liquidum  nervosum,  an  involuntary  strabis- 
“ mus  will  be  occasioned. 

“ Though  the  fifth  and  sixth  pair  of  nerves 
cc  form  entirely  the  beginning  of  the  intercostal  be- 
<c  fore  it  goes  out  of  the  scull,  yet  because  several 
tc  other  nerves  contribute  towards  the  formation  of 
Ci  its  trunk  before  it  sends  off  any  branches,  I shall 
“ supersede  the  description  of  it  till  the  original 
nerves  are  spoke  to. 


236 


NEKVES. 


44  The  seventh  pair  appears  coming  out  from 
44  the  side  of  the  root  of  the  annular  process,  and 
44  entering  the  meatus  auditorius  interims,  and 
44  immediately  dividing,  one  part  soon  loses  its 
44  firm  coats,  and  is  expanded  on  the  inmost  ca- 
64  mera  of  the  ear,  while  the  other  passing  through 
44  the  aquoeductus  Fallopii  comes  out  of  the  scull 
44  involved  in  all  its  coats  between  the  styloide  and 
44  mastoide  processes ; whence  we  see  the  reason  of 
44  the  first  being  named  portio  mollis,  i\nd  the 
44  other  dura  : this  last  after  its  exit  supplies  the 
44  musculi  obliqui  capitis  stylohyoidei,  styloglossi, 
44  and  stylopharyngeei,  and  platysma  myoides,  on 
44  which,  and  to  the  skin  of  the  neck,  a great  num- 
44  ber  of  its  small  filaments  run,  which  are  somc- 
44  times  cut  in  opening  the  jugular  vein,  whence 
44  pain  at  first,  and  a little  numbness  afterward. 
44  The  superior  branches  of  it  supply  the  parotid 
44  gland,  external  ear,  and  whole  side  of  the  face 
44  as  far  forwards  as  the  chin.  It  is  said  to  corm 
44  municate  thrice  with  the  fifth  pair,  and  twice 
44  with  the  second  vertebra.  Whether  may  not  we 
44  hence  see  some  reason  why  the  head  is  so  soon 
44  moved  by  the  impression  of  sound  on  our  ear  ? 

44  The  eighth  pair  of  nerves  derive  their  origin 
44  from  the  side  of  the  basis  of  the  corpora  olivaria, 
44  where  their  loose  filamentous  texture  is  very  con- 
44  spicuous ; then  running  to  the  hole  common  to 
44  the  ossa  temporum  and  occipitis,  they  are  there 
54  joined  by  the  accessorius  WiUisii,  which  has  its 


NERVES. 


237 


« beginning  from  the  two  or  three  superior  nerves 
44  of  the  medulla  spinalis,  and  mounts  upwards 
44  thither,  to  pass  out  with  the  eighth  pair,  at  that 
44  common  foramen  just  now  mentioned  : very 
44  soon  after  they,  wrapped  up  in  the  same  coat, 
44  have  got  out  of  the  cranium,  the  accessorius  sep- 
44  arates  from  its  companion,  and  after  passing 
44  through  the  middle  of  the  musculus  mastoideus, 
44  is  lost  in  the  musculus  trapezius  and  rhomboides 
44  scapulae  ; while  the  large  trunk,  which,  from  the 
44  great  number  of  branches  it  sends  off,  obtains 
44  the  name  of  vagus,  runs  straight  down  the  neck, 
44  near  the  carotid  artery,  in  its  course  giving  seve- 
44  ral  branches  to  the  larynx  : when  entered  the 
44  thorax,  it  splits  into  two  ; the  anterior  serves  the 
44  pericardium,  sends  branches  to  join  with  those 
44  of  the  intercostal  that  go  to  the  heart,  and  then 
44  on  the  right  side  turns  round  the  subclavian,  and 
44  on  the  left  round  the  ductus  arteriosus,  to  mount 
44  again  upwards  at  the  side  of  the  oesophagus  to 
44  be  lost  in  the  larynx.  This  recurrent  branch  it 
44  is  that  we  are  earnestly  cautioned  to  avoid  in 
44  bronchotomy,  though  by  reason  of  its  deep  situ- 
44  ation  we  are  in  no  hazard  of  it.  If  both  these 
44  nerves  were  cut,  it  is  probable  the  voice  -would 
44  not  be  entirely  lost  as  long  as  the  superior  branch- 
44  es  still  supply  the  larynx.  The  posterior  branch 
44  of  the  eighth  pair  goes  along  with  the  oesophagus, 
44  and  supplies  the  lungs,  the  gula,  and  stomach 
44  very  plentifully  ; and  as  all  the  nerves  bestowed 


238 


NERVES. 


44  on  this  viscus  enter  at  the  superior  orifice  of  it, 
64  the  sensation  here  must  be  very  acute ; whence 
44  Helmont  imagined  the  mouth  of  the  stomach 
44  to  be  the  seat  of  the  soul.  What  remains  of 
44  this  par  vagum  is  adjoined  to  the  intercostal  im- 
44  mediate  below  the  diaphragm. 

44  The  ninth  pair  appear  first  at  the  inferior 
44  part  of  the  corpora  pyramidalia,  and  march  out 
44  at  their  proper  holes  of  the  occipitis,  and  after 
44  sending  off  some  nerves  to  the  glandula  thyroi- 
44  dea,  and  musculi  sterno-hyoidei,  and  sterno^ 
44  thyroidei,  are  lost  in  the  substance  of  the  tongue. 
44  Authors  have  disputed  whether  this  ninth  or 
44  the  fifth  is  the  gustatory  nerve  ; the  old  opinion 
44  in  favour  of  the  ninth  is  to  me  most  probable, 
44  because  the  fifth  is  no  where  else  employed  as 
64  an  organ  of  sensation,  because  the  ninth  seems  to 
44  penetrate  the  substance  of  the  tongue  more,  while 
44  the  fifth  is  spent  on  the  muscles. 

44  The  tenth  pair  comes  out  from  the  beginning 
44  of  the  medulla  spinalis,  betwixt  the  os  occipitis 
44  and  first  vertebra  colli,  and  is  all,  except  what 
44  goes  to  the  ganglion  of  the  intercostal,  spent  on 
44  the  musculi  obliqui,  and  extensores  capitis. 

44  The  only  nerves  proceeding  from  the  ence- 
44  phalon  not  described,  are  the  reflected  branches 
44  of  the  fifth  and  sixth,  which  indeed  are  so  small 
44  and  pappy,  and  hid  by  the  carotid  artery  as  they  go 
54  out  with  it  in  its  crooked  canal,  as  not  to  be  easily 
44  traced  ; but  whenever  they  have  escaped  from  the 


■JfERVESi 


233 


u os  petrosum,  they  are  joined  by  branches  from 
4t  the  eighth,  ninth,  tenth,  and  first  and  second 
“ spinal,  and  the  largest  ganglion  of  the  body  is 
“ formed,  from  which  the  nerve  named  now  in- 
“ tercostal,  goes  out  to  descend  down  the  neck 
<c  with  the  carotid,  supplying  in  its  course  the  mus- 
“ culi  flexores  of  the  head  and  neck,  and  commu- 
“ nicating  with  the  cervical  nerves.  As  the  inter- 
“ costal  is  about  to  enter  the  thorax,  it  auain  forms 
s<  a ganglion,  from  which  the  nerves  to  the  trachea 
“ arteria  and  the  heart  are  supplied,  which  join  with 
“ the  branches  of  the  eighth,  and  pass  between  the 
“ two  large  arteries  and  auricles  to  the  substance 
“ of  that  muscle.  Now  let  any  one  consider  the 
“ egress  of  the  intercostal,  and  close  course  of  it 
<s  and  the  eighth  with  the  carotid  artery,  and  this 
“ manner  of  entry  of  the  cardiac  nerves,  surely 
“ the  alternate  constriction  and  relaxation  of  the 
<c  heart  will  appear  necessarily  depending  on  the 
“ disposition  of  these  organs  of  motion,  the  nerves. 
“ The  intercostal  after  this  runs  down  on  the  side 
M of  the  vertebras  thoracis,  having  additional  nerves 
<c  constantly  sent  to  it  from  between  these  verte- 
“ brae,  till  it  pass  through  its  own  proper  hole  of 
te  the  diaphragm  y whence  it  again  forms  another 
“ ganglion  close  by  the  glandulas  renales,  into 
<c  which  the  eighth  pair  enter.  From  such  a knot 
“ on  each  side,  the  nerves  of  the  guts,  liver,  spleen, 
“ pancreas,  and  kidneys  are  derived  ; nay,  the  ex - 
(i  tremity  of  this  nerve  is  sent  down  to  the  pelvis 


240 


MERVES. 


I 

44  to  supply  the  parts  there.  Hence  the  great  syrru 
44  pathy  of  these  parts  may  be  easily  deduced,  and 
44  a reason  may  be  given  of  the  violent  vomiting 
44  that  commonly  attends  a nephritis,  and  of  the 
44  belching,  colic,  and  stomach  aches,  which  often 
44  ensue  on  the  obstructions  of  the  menstrua. 

44  Before  I proceed  to  the  spinal  nerves,  I 
44  shall  set  down  the  order  in  which  these  nerves 
44  already  described,  are  to  be  dissected,  in  order 
44  to  demonstrate  them  all  in  one  subject,  but  to 
44  them  must  assume  the  three  first  cervical  nerves, 

44  the  reason  of  which  will  be  evident  afterwards. 

44  Portio  dura  septimi,  frontalis  quinti,  facia- 
44  lis  quinti,  mentalis  quinti,  spinalis  sccundus, 

44  spinalis  primus,  olfactorius,  ophthalmicus  quin- 
44  ti,  motorius  oculi,  patheticus  sextus,  opticus, 

44  maxillaris  inferior  quinti,  maxillaris  superior 
44  quinti,  accessorius  Willisii,  nonus,  decimus,  oc- 
44  tavus  intercostalis,  portio  mollis  septimi. 

44  The  thirty  pair  of  nerves  proceeding  from 
44  the  medulla  spinalis  are  generally  divided  into 
44  four  species  ; of  the  neck  seven,  of  the  back 
44  twelve,  of  the  loins  five,  and  of  the  os  sacrum 
44  six.  Now  as  the  medulla  spinalis  has  none  of 
44  these  inequalities  so  observable  on  the  medulla 
44  oblongata  encephab,  the  rise  of  the  nerves  is  not 
44  so  accurately  described,  being  only  determined  by 
44  the  bone  through  which  they  pass. 

44  The  first  cervical  goes  out  between  the  first 
44  and  second  vertebra,  and,  after  sending  off  branches 


NERVES.  241 

<e  that  communicate  with  the  tenth  and  second 
“ vertebrale,  is  spent  on  the  musculus  flexus  colli, 
“ splenius,  complexus,  and  teguments  of  the  occi-* 
u put. 

“ The  second  cervical  communicates  with  the 
ec  ninth,  and  with  the  first  and  third  of  the  neck, 
ec  and  then  is  distributed  to  the  teguments  of  the 
6i  neck  and  side  of  the  head,  and  to  the  glandula 
fiC  parotis  and  external  ear,  where  it  joins  with  the 
cs  portio  dura. 

“ The  third  of  the  neck  passes  out  between  the 
“ third  and  fourth  vertebra,  soon  communicating 
“ with  the  second*  and  sending  down  a large 
“ branch,  which  being  joined  by  another  from 
cc  the  fourth  forms  the  phrenic  nerve  that  runs 
“ along  the  pericardium  to  be  lest  in  the  dia- 
te  phragm.  In  this  course  the  right  phrenic  is  o« 
“ bliged  to  make  a small  turn  round  that  part  of  the 
“ pericardium  which  covers  the  apex  of  the  heart. 
“ Hence  it  is  that  such  as  have  strong  palpita- 
fi  tions  of  the  heart  feel  a pungent  acute  pain  im- 
“ mediately  above  the  right  orifice  of  the  stomach. 
u The  other  branches  of  this  third  cervical  are 
“ distributed  to  the  musculus  trapezius  and  del- 
“ toides,  and  to  the  teguments  on  the  top  of  the 
<c  shoulder ; which,  with  the  description  of  the 
“ eighth  pair,  leads  us  evidently  to  the  reasons  of 
“ the  divine  Hippocrates’s  observation,  that  an. 
“ inflammation  of  the  liver  is  generally  attend- 
ed with  a hiccough,  and  a suppuration  of  that 
h h 


U 


242 


NfcELVES. 


cc  viscus,  with  a violent  pain  on  the  top  of  the 
“ shoulder.  However,  we  are  not  hence  to  con- 
<c  elude  so  generally,  as  I have  observed  physicians 
(i  frequently  do,  that  if  the  hypochondria  are  ef- 
“ fected,  and  this  pain  of  the  shoulder  is  felt,  there- 
“ fore  the  liver  is  suppurated  ; for  any  other  cause 
“ stimulating  or  stretching  the  nerves,  such  as  in- 
<c  flammation,  wounds,  scirrhous  or  steatomatous 
“ tumours,  &c.  may  produce  the  same  effect. 

“ The  fourth  cervical,  after  sending  off  that 
cc  branch  which  joins  with  the  third  to  form  the 
“ phrenic,  runs  straight  to  the  axilla,  where  it 
<c  meets  with  the  fifth,  sixth,  and  seventh  cervicals, 
<c  and  first  dorsal  that  escape  in  the  interstices  of  the 
“ musculi  scaleni  ; and  all  of  them  are  so  often 
“ conjoined  and  blended,  after  they  have  given  off 
“ nerves  to  the  muscles  of  the  neck,  scapula,  arm, 
“ and  thorax,  and  to  the  teguments,  that  when  the 
“ several  ramifications  go  off  in  the  axilla  to  the 
“ different  parts  of  the  superior  extremity,  it  is  im- 
“ possible  to  determine  which  of  them  the  branches 
“ belong  to.  The  considerable  branches  into  which 
“ they  are  divided,  are  six  ; these  I shall  presume  to 
u give  proper  distinguishing  names  to,  by  which  the 
“ description  will  be  less  confused,  and  the  young 
“ anatomist’s  memory  better  assisted  to  retain  what 
“ is  so  difficult  to  represent  in  words. 

“ 1.  Cutaneus  runs  down  the  fore  part  of  the 
“ arm,  and  serves  the  teguments,  as  far  as  the  palm 
“ of  the  hand  and  fingers. 


VERVES. 


243 


« 2.  Musculo-cutaneus,  or  perforans  casserii, 
passes  through  the  musculus  coracobrachialis,  and 
i(  after  supplying  the  biceps  and  brachiasus  internus 
“ is  spent  on  the  teguments  of  the  back  of  the  cu- 
“ bitus  and  liand. 

“ 3.  Muscularis,  that  runs  down  the  fore  part 
“ of  the  arm  to  be  lost  in  the  musculi  flexores  carpi, 
“ digitorum,  &c. 

“ 4.  Ulnaris,  which  supplies  the  extensores 
“ cubiti,  and  teguments  of  the  elbow,  and  then 
“ passing  through  the  sinuosity  at  the  back  of  the 
“ external  condyle  of  the  humerus,  runs  along  the 
“ ulna,  where  it  gives  twigs  to  the  teguments  and 
“ neighbouring  muscles  ; at  length  is  lost  in  the 
“ back  of  the  hand,  musculi  interrossei,  and  lumbri- 
“ cales  in  the  little  finger,  and  side  of  the  ring 
“ finger  next  to  this.  The  course  of  this  nerve  is 
“ sufficiently  felt  when  we  lean  on  our  elbow,  by 
“ the  insensibility  and  prickling  pain  in  the  parts 
u to  which  it  is  distributed. 

“ 5.  Radialis  goes  down  the  fore  part  of  the 
arm,  near  the  radius,  bestowing  branches  in  its 
“ progress  on  the  circumjacent  muscles,  and  at  the 
“ ligamentum  annulare  carpi  splitting,  is  sent  to 
<c  the  thumb,  fore  finger,  middle  finger,  and  half 
“ the  ring  finger,  and  to  the  back  of  the  hand. 

“6.  Articularis  runs  almost  round  the  top  of 
<c  the  os  humeri,  and  serves  the  musculi ' exten- 
sores  cubiti,  retractores,  and  elevatores  humeri, 


244 


NERVES. 


44  By  a strong  and  continued  pressure  on  these 
44  nerves,  by  crutches  or  any  such  hard  substance, 
44  a palsy  and  atrophy  of  the  arm  may  be  occa- 
44  sioned. 

44  The  twelve  dorsal  nerves  all  communicate 
44  with  one  another  : as  soon  as  they  make  their 
44  way  out  betwixt  the  vertebrx,  each  of  them 
44  gives  a posterior  branch  to  the  musculi  erectores 
44  trunci  corporis  ; the  first,  after  having  sent  off 
44  the  brachial  nerve,  already  described,  is,  after  the 
44  same  manner  with  the  succeeding  eight,  be- 
44  stowed  on  the  pleura  and  intercostal  muscles  ; the 
44  tenth  and  eleventh  are  most  of  them  sent  to  the 
44  abdominal  muscles  ; the  twelfth  communicates 
44  with  the  first  lumbar,  and  is  bestowed  on  the 
44  musculus  quadratus  lumbalis  and  iliacus  internus. 

44  The  fifth  lumbar  also  communicates  and  gives 
44  posterior  branches  -,  the  first  sends  several  branches 
44  to  the  abdominal  muscles,  and  psoas,  and  iliacus, 
44  while  others  go  from  it  to  the  teguments  and 
44  muscles  on  the  superior  and  anterior  part  of  the 
44  thigh,  and  the  main  trunk  of  it  is  lost  in  the 
44  crural.  The  second  passes  through  the  psaos 
44  muscle,  and  is  distributed  much  as  the  former. 
44  The  third  is  lost  in  the  musculus  pectineus. 
44  Branches  proceeding  from  the  first,  second,  and 
44  third,  make  up  one  trunk,  which  runs  along  the 
44  anterior  part  of  the  pelvis,  and  slipping  through  a 
44  small  sinuosity  in  the  anterior  part  of  the  foramen 
f4  magnum  ossis  ischii,  is  spent  in  the  musculus 


SERVES. 


245 


<c  triceps.  This  nerve  is  commonly  known  by  the 
44  name  of  obturator,  or  posterior  crural  nerve. 
44  By  the  union  of  branches  from  the  first,  second, 
“ third,  and  fourth  lumbar  nerves,  the  anterior 
44  crural  nerve  is  formed,  which  running  along  the 
44  musculus  psoas,  escapes  with  the  large  blood 
64  vessels,  out  of  the  abdomen  below  the  tendinous 
44  arcade  of  its  muscles,  and  is  distributed  to  the 
44  muscles  and  teguments  on  the  fore  part  of  the 
44  thigh  : one  branch  of  this  crural  nerve  accom- 
44  panics  the  vena  saphena  as  far  as  the  ancle.  Now 
44  let  us  imagine  the  situation  of  the  kidney  upon, 
44  and  the  course  of  the  ureter  over  these  nerves, 
44  and  we  shall  not  be  surprised,  that  in  a nephritis 
44  the  trunk  of  the  body  cannot  be  raised  erect 
44  without  great  pain  ; that  the  thigh  loses  of  its 
44  sensibility,  and  that  it  is  drawn  forwards.  The 
44  remainder  of  the  fourth  and  the  fifth  lumbar 
44  nerves  join  with  the  first,  second,  and  third  that 
44  proceed  from  the  os  sacrum  : these  five,  when 
44  united,  constitute  the  largest  nerve  of  the  body, 
44  so  well  known  by  the  name  of  the  sciatic,  or 
44  ischiatic  nerve,  which  seems  to  be  bigger,  in 
44  proportion  to  the  part  for  the  use  of  which  it  is, 
44  than  the  nerves  of  any  other  part  are  ; the  de- 
44  sign  of  which  may  be  to  afford  sufficient  strength 
44  to  the  muscles  of  the  lower  extremity,  for  cx- 
44  erting  a force  superior  to  what  is  required  in  any, 
44  other  part  of  the  body.  When  this  nerve  is  any 
44  way  obstructed,  we  see  how  unable  we  are  to 


245 


NERVES. 


ee  support  ourselves,  or  to  walk.  The  sciatic  nerve 
44  then  goes  out  at  the  large  hollow  behind  the 
cc  great  tubercle  of  the  os  ischium,  and  passing 
44  over  the  quadrigemini  muscles,  runs  down  the 
44  posterior  part  of  the  thigh,  giving  off,  every 
44  where  as  it  goes,  nerves  to  the  teguments  and 
44  muscles  of  the  thigh  and  leg.  At  the  ham  it 
44  splits  into  two  ; the  smaller  mounts  over  the  fi- 
44  bula,  and  serving  the  musculi  peronei,  flexores 
44  pedis,  and  extensores  digitorum,  is  continued  to 
“ the  toes  along  the  broad  of  the  foot,  while  the 
44  larger  trunk  sinks  under  the  musculi  gemclli, 
44  and  then  divides  ; one  is  spent  in  the  muscles 
44  at  the  back  of  the  leg  and  teguments,  while 
44  the  other  is  continued  by  the  inner  ancle  to  the 
44  foot,  and  then  subdivides  ; one  branch  is  distrib^ 
44  uted  after  the  same  manner  as  the  ulnaris,  and 
44  the  other  as  the  radialis  in  the  hand. 

44  The  other  nerves  that  come  out  of  the  os  sa- 
44  crum,  are  sent  to  the  organs  of  generation,  mus- 
44  culi  levatores  ani,  and  obturatores. 

44  These  nerves  of  the  medulla  spinalis  may  all 
44  be  dissected  and  demonstrated  in  the  same  order 
44  in  which  they  are  described.”  For  this  accurate 
description  of  the  nerves  I am  obliged  to  Mr. 
Monro. 

The  nerves  seem,  when  examined  with  a mi- 
croscope, to  be  bundles  of  strait  fibres  not  commu- 
nicating with  one  another  : and  I am  inclined  to 
think,  that  every  the  minutest  nerve  terminating 


NERVES. 


247 


in  any  part,  is  a distinct  cord  from  its  origin  in  the 
brain  or  spinal  marrow  ; or  else  I do  not  see  how 
they  could  produce  distinct  sensations  in  every  part : 
and  the  distinct  points  of  sensation  throughout  the 
body  are  so  very  numerous,  that  the  whole  body  of 
nerves  (which  taken  together  would  not  make  a 
cord  of  an  inch  diameter)  must  be  divided  into  such 
a number,  to  afford  one  for  every  part  that  has  a 
distinct  sensation,  that  surely  such  a nerve  would 
be  too  small  to  be  seen  by  the  best  microscope. 
They  all  pass  in  as  direct  courses  to  the  places  they 
serve,  as  is  possible,  never  separating  nor  joining 
with  one  another  but  at  very  acute  angles,  unless 
where  they  unite  in  those  knots  which  are  called 
ganglions,  the  use  of  which  I do  not  pretend  to 
know  ; they  make  what  appears  to  be  a communi- 
cation of  most  of  the  nerves  on  the  same  side,  but 
never  join  nerves  on  opposite  sides. 

That  the  nerves  are  instruments  of  sensation, 
is  clearly  proved  from  experiments,  but  how  they 
convey  those  sensations  to  the  brain,  is  matter  of 
dispute.  The  most  general  opinion  is  ; that  they 
are  tubes  to  contain  animal  spirits,  by  whose  mo- 
tions these  sensations  are  conveyed  : and  diligent 
inquiry  has  been  made  to  discover  their  cavities, 
but  hitherto  in  vain  ; and  if  each  nerve  is  distinct 
from  its  origin,  as  I have  endeavoured  to  shew,  and 
too  small  to  be  the  object  of  the  best  microscope,  I 
do  not  see  how  such  cavities  are  like  to  be  discov- 


NERVES. 


£48 

ered.  Nevertheless  nerves  may  be  tubes,  and 
possibly  a fluid,  whose  cohesion  is  very  little,  and 
whose  parts,  no  finer  than  light,  may  move  freely 
in  them.  Those  who  deny  animal  spirits  in  the 
nerves,  suppose  that  the  sensation  is  conveyed  by  a 
vibration.  To  which  it  is  objected,  that  they  are 
slack,  moist,  and  surrounded  with  soft  parts,  and 
are  therefore  unfit  for  vibrations,  as  indeed  they 
are  for  such  as  are  made  on  the  strings  of  a musi- 
cal instrument  ; but  the  minutest  vibrations,  such 
as  they  cannot  be  without,  may,  for  aught  we 
know,  be  as  suflicient  for  this  end,  as  the  impulse 
of  light  upon  the  retina,  is  for  the  sense  of  seeing. 
So  that  perhaps  sensations  may  be  conveyed  ei- 
ther, or  both  ways.  However,  it  being  usually 
taken  for  granted,  that  it  must  be  one  of  these 
ways  at  least,  the  advocates  for  each  have  rather 
endeavoured  to  support  their  opinions  by  argu- 
ments against  the  probability  of  the  other,  than  by 
reasons  offered  for  their  own. 


TAB.  XXI 


TABLES. 


249 


TABLE  XXL 

1 Larynx. 

2 The  internal  jugular  Vein. 

3 The  subclavian  vein. 

4 Cava  descendens. 

5 The  right  auricle  of  the  heart, 

6 The  right  ventricle. 

7 Part  of  the  left  ventricle. 

8 Aorta  ascendens. 

9 Arteria  pulmonalis. 

10  The  right  lobe  of  the  lungs,  part  of  which  is 

cut  off  to  shew  the  great  blood  vessels. 

11  The  left  lobe  of  the  lungs. 

12  The  diaphragm. 

13  The  liver. 

14  The  ligamentum  rotundum. 

15  The  gall-bladder. 

16  The  stomach,  pressed  by  the  liver  towards  the 

left  side. 

17  The  small  guts. 

18  The  spleen. 


250 


TABiES. 


TABLE  XXIL 

1 The  under  side  of  the  liver, 

2 Lisjamentum  rotundum. 

3 The  gall-bladder. 

4 The  pancreas. 

5 The  spleen. 

G The  kidney. 

7 Aorta  ascendens. 

8 Vena  cava  ascendens. 

9 The  emulgent  vein. 

10  A probe  under  the  spermatic  vessels  and  the 

arteria  mesenterica  inferior,  and  over  the 
ureters. 

11  The  ureter. 

12  The  iliac  vessels. 

13  The  rectum  intestinum. 

14  The  bladder  of  urine. 


TAB  .xxir. 


TAB  .XXIII. 


r.  i 


TABLES,. 


251 


TABLE  XXIII. 

1 Part  of  the  intestinum  jejunum. 

2 The  valvulae  conniventes,  as  they  appear  in  a dri- 

ed preparation. 

3 The  venae  lacteae  arising  from  the  gut,  and  pass- 

ing through  part  of  the  mesentery. 

4 Part  of  the  descending  aorta. 

5 Arteria  coeliaca. 

6 Mesenterica  superior. 

7 Emulgentes. 

8 Spermaticae. 

9 Some  of  the  branches  of  the  mesenterica  inferior 

that  are  bestowed  upon  the  guts. 


252 


TABLES. 


TABLE  XXIV. 

1 Extreme  branches  of  the  ven^  porta,  as  they 

arise  from  the  guts. 

2 All  the  branches  of  the  vena  porta,  united  be- 

fore it  enters  the  liver- 

3 The  branches  of  the  vena  porta,  as  they  are  dis- 

tributed in  the  liver. 


TA.B.XXIV- 


P 2 52,- 


TAB.  XXV. 


-P.  2.5  II 


-TABLES. 


253 


TABLE  XXV. 

1 Brandies  of  the  vena  cava  in  the  liver. 

2 Part  of  the  vena  cava  ascendens. 

3 Part  of  the  right  auricle. 

4 Cistis  hepatica. 

5 Ductus  sisticus. 

6 Ductus  hepaticus. 

7 Ductus  pancreaticus. 

8 The  entrance  of  the  ductus  communis  into  the 

duodenum. 


! 


254 


tables. 


TABLJE  XXVI, 

1 The  left  subclavian  vein. 

2 The  internal  jugular. 

3 Part  of  the  vena  azygos. 

4 Part  of  the  descending  aorta. 

5 The  subclavian  artery. 

6 Some  of  the  lacteals  entering  the  receptaculum 

chyli. 

7 Some  lymphatics  entering  the  receptaculum 

chyli. 

8,  9 The  Ductus  thoracicus. 

10  The  entrance  of  the  thoracic  duct  into  the  sub- 
clavian vein. 


TABLES.  255 

TABLE  XXVIL 

1 The  humeral  artery. 

2 Cubitalis  superior. 

3 Cubitalis  inferior,  which  ends  in  the  hand  and 

the  fingers,  and  communicates  with  the 
cubitalis  superior,  under  the  muscles  of  the 
thumb. 

4 The  place  where  the  cubitalis  media  is  given 

off. 

5 The  superior  cubital  nerve. 

6 The  inferior  cubital  nerve,  which  passes  un- 

der the  inner  extuberance  of  the  os  hu- 
meri ; both  these  nerves  give  off  branches 
as  they  pass,  and  end  in  the  thumb  and 
fingers. 


256 


TABLES. 


TABLE  XXVIII. 

1 Part  of  the  biceps  flexor  cubiti. 

2 The  fascia  tendinosa  from  that  muscle,  which 

is  liable  to  be  pricked  in  bleeding  in  the  ba- 
silic vein. 

3 The  humeral  artery,  on  each  side  of  which  is  a 

large  vein. 

4 Vena  cephalica. 

5 Mediana. 

6 Basilica. 

7 A tumor  formed  in  the  centre  of  the  cubital 

nerve,  a little  above  the  bend  of  the  arm  ; it 
was  of  the  cistic  kind,  but  contained  a trans- 
parent jelly  ; the  filaments  of  the  nerve  were 
divided  and  ran  over  its  surface.  This  tu- 
mor occasioned  a great  numbness  in  all  the 
parts  that  nerve  leads  to,  and  excessive  pain 
upon  the  least  touch  or  motion.  This  opera, 
tion  was  done  but  a few  weeks  since,  the  pain 
is  entirely  ceased,  the  numbness  a little  in- 
creased,  and  the  limb,  as  yet,  not  wasted. 


TABLES. 


257 


TABLE  XXIX. 

1 The  medulla  spinalis,  from  whence  arise  the 

nerves  that  pass  out  between  the  vertebrae. 

2 The  brachial  nerves. 

3 The  beginning  of  the  cauda  equina. 

4 The  anterior  crural  nerves. 

5 The  posterior  crural  nerves. 

6 The  descending  intercostal. 

7 Nerves  of  the  neck. 

3 The  brachial  nerves. 

9  A ganglion  in  the  descending  intercostal  nerve. 

10  Branches  from  the  intercostal  nerve  to  the 

viscera. 

11  A probe  passed  under  some  of  the  intercostal 

nerves  that  pass  out  between  the  ribs. 

12  The  anterior  crural  nerves. 


258 


TABLES. 


TABLE  XXX. 

1 The  animalculse  in  semine  masculino,  as  they 

appeared  in  a microscope,  in  a space  as  small 
as  a pin’s  head. 

2 The  circulation  of  the  blood  in  a fish’s  tail,  a& 

it  appeared  in  a microscope. 

3 An  artery,  as  it  is  spread  in  a membrane. 

4 A vein,  as  it  is  spread  in  a membrane. 


THE 


ANATOMY 

OF  THE 

HUMAN  BODY. 


BOOK  IK 


CHAPTER  I. 

€>F  THE  URINARY  AND  GENITAL  PARTS  OF  MEN, 
TOGETHER  WITH  TEIE  GLANDULE  RENALES. 

The  urinary  parts  are  the  kidneys  with  their 
vessels  and  bladder  of  urine. 

The  kidneys  of  men  are  like  those  of  hogs  ; 
the  two  weigh  about  twelve  ounces  ; they  are 
seated  towards  the  upper  part  of  the  loins  upon 
the  two  last  ribs  ; the  right  under  the  liver,  and  a 
little  lower  than  the  other,  and  the  left  under  the 
spleen.  Their  use  is  to  separate  the  urine  front  the 
blood,  which  is  brought  thither  for  that  purpose 


260 


URINARY  AND  GENITAL 


by  the  emulgent  arteries ; and  what  remains  from 
the  secretion,  is  returned  by  the  emulgent  veins, 
while  the  urine  secreted  is  carried  off  through  the 
ureters  to  the  bladder.  I have,  in  three  different 
subjects,  taken  stones  out  of  the  loins,  which  had 
made  their  ways  from  the  kidneys  through  the  mus- 
cles to  the  common  integuments,  where  upon  open- 
ing the  skin  only,  the  stones  appeared  with  a quan- 
tity of  matter  and  urine.  We  have  heard  of  ope- 
rators who  have  cut  for  the  stone  in  the  kidneys  ; 
but  I will  venture  to  affirm,  that  those  cases  were 
no  other  than  these,  though  unfairly  related. 

The  ureters  are  tubes  about  the  bigness  of  goose- 
quills,  and  about  a foot  long  ; they  arise  from  the 
hollow  side  of  the  kidneys,  and  end  in  the  bladder 
near  its  neck,  running  obliquely  for  the  space  of 
an  inch  between  its  coats  ; which  manner  of  enter- 
ing is  to  them  as  valves.  The  beginning  of  the 
ureters  in  the  kidneys  are  the  tubuli  urinarii,  which 
joining  form  the  pelvis  in  each  kidney.  Between 
the  tubuli  urinarii,  authors  have  remarked  small 
papillae ; and  the  parts  which  are  distinguished  by 
a clearer  colour  they  call  glandulae. 

The  bladder  of  urine  is  seated  in  a duplicature 
of  the  peritonaeum  in  the  lower  part  of  the  pelvis 
of  the  abdomen  ; its  shape  is  orbicular,  and  its 
coats  are  the  same  with  those  of  the  guts  and  other 
hollow  muscles  already  described  ; viz.  an  external 
membranous,  a middle  muscular,  which  is  the  mus^ 
cuius  detrusor  urinae,  and  an  inner  membranous 


PARTS  OF  MEN. 


261 


coat,  exceeding  sensible,  as  is  fully  shewn  in  the 
cases  of  the  stone  and  gravel.  The  use  of  this 
nice  sense  is  to  make  it  capable  of  that  uneasiness 
which  excites  animals  to  exclude  their  water,  when 
the  bladder  is  extended.  This  sense  is  so  delicate, 
that  no  fluid  but  natural  urine  can  be  long  endured, 
even  pale  urine,  or  urine  with  matter  in  it,  in  a 
degree  excite  the  symptoms  of  the  stone,  and  force 
the  person  to  void  the  urine.  Sometimes  much 
matter  from  the  kidneys  will  excite  vehement  symp- 
toms ; and  this  being  found  in  the  urine,  and  the 
pain  being  observed  in  the  bladder  only,  the  kidneys 
having  little  sense  of  pain,  it  is  usually  accounted 
for  from  ulcers  in  the  bladder,  which  I have  never 
found  one  instance  of  in  all  the  numbers  that  I have 
opened  in  this  case.  Indeed  the  bladder  is  some- 
times ulcerated,  but  that  destroying  part  of  the  in- 
ner coat,  the  others  stretch  and  ulcerate  till  the  urine 
bursts  through  into  the  cellular  membrane  of  the  pe- 
ritonaeum, and  cause  a most  miserable  death.  This 
case  is  very  rare  in  men,  and  much  more  so  in  wo- 
men. I have  seen  cancerous  ulcers  open  the  bladder 
into  the  uterus,  but  these,’  I think,  have  begun  in 
the  uterus.  All  these  cases  have  symptoms  like  the 
stone ; and  not  these  only,  but  all  diseases  of  the 
uterus  which  disturb  the  bladder,  and  even  impost- 
humations  or  tumors  that  press  upon  the  bladder, 
all  give  the  same  symptoms  with  the  stone ; except 
that  of  a needless  disposition  to  stool  at  the  time  of 
making  water.  Some  anatomists,  not  thinking  how 


252 


URINARY  AND  G£ni'TAL 


soon  fluids  taken  into  the  stomach,  and  not  retained 
there  by  being  mixed  with  solids,  may  pass  into  the 
blood,  as  the  effects  from  drinking  strong  liquors  or 
laudanum,  or  drinking  without  eating  when  we  are 
hot,  sufficiently  shew  ; and  also  not  considering  the 
shortness  of  the  course  from  the  stomach  to  the  kid- 
neys this  way,  together  with  the  size  of  the  emul- 
gent  arteries,  and  the  velocity  of  the  blood  in  them 
have  imagined  and  affirmed,  that  there  must  be 
some  more  immediate  course  from  the  stomach  or 
guts  to  the  bladder  ; and  not  considering  either  how 
Such  a course  would  have  interrupted  one  great  end 
in  the  animal  economy,  or  that  vessels  fit  to  fill 
the  bladder  faster  than  the  ureters,  must  have  been 
too  large  to  be  concealed  ; nor,  which  proves  it  be- 
yond contradiction,  that  the  bladder  is  empty  when 
the  kidneys  cease  to  do  their  office ; which  is  fre- 
quently taken  for  a suppression  of  urine  in  the  blad- 
der. If  in  this  last  case,  upon  making  a pressure  on 
the  region  of  the  bladder,  the  patient  does  not  feel 
great  pain, it  is  scarce  worth  while  to  pass  a catheter  to 
search  for  urine.  In  suppressions  of  urine,  wheth- 
er merely  inflammatory,  or  from  the  gout,  or 
from  an  inflamed  stricture  in  the  urethra,  I have 
found  nothing  so  effectual  as  bleeding  and  purging. 
In  a sanguine  large  man,  where  the  penis  was  too 
much  inflamed  to  suffer  the  catheter  to  pass,  I took 
away  three  times  twenty-four  ounces  of  blood,  and 
gave  a purging  clyster,  and  two  strong  purges,  all 
within  the  space  of  twenty  hours,  which  saved 


PARTS  OF  MEN. 


2 65 


the  patient,  and  delivered  him  from  excessive  tor- 
ment. Such  practice  may  seem  very  severe,  but 
in  this  case  no  time  is  to  be  lost ; if  the  urine  can 
be  drawn  off,  the  method  of  cure  is  still  the  same, 
but  to  be  practised  in  a gentler  manner. 

Glandulae  renales  are  two  glands  seated  imme- 
diately above  the  kidneys,  of  no  certain  figure, 
nor  do  we  know  their  use ; but  always  paint  and 
describe  them  with  the  urinary  parts,  because  of 
their  situation  : in  a very  young  foetus  they  are 
larger  than  the  kidneys,  and  in  an  adult  but  a little 
larger  than  in  a foetus.  They  receive  a great  many 
small  arteries,  and  return  each  of  them  one  or  two 
veins.  In  their  inside  is  a small  sinus,  tinctured 
with  a sooty-coloured  liquor. 

The  testes  are  seated  in  the  scrotum  ; their  of- 
fice is  to  separate  the  seed  from  the  blood  ; they 
are  said  to  have  four  coats,  two  common,  and 
two  proper.  The  common  are  the  outer  skin  and 
a loose  membrane  immediately  underneath,  called 
dartos.  The  first  of  the  proper  is  the  processus  va- 
ginalis ; it  is  continued  from  the  peritonaeum  to  the 
testicle,  which  it  encloses  with  all  its  vessels,  but  is 
divided  by  a septum,  or  an  adhesion  immediately 
above  the  testicle,  so  that  no  liquor  can  pass  out  of 
that  part  of  this  membrane,  which  encloses  the  sper- 
matic vessels,  into  that  which  encloses  the  testicle. 
Large  quantities  of  water  are  sometimes  found  in 
either  or  both  of  these  cavities,  which  disease  is 
easily  remedied  by  a puncture  with  a lancet  ; but 


i 


264-  URINARY  AND  GENITAL 

rarely  cured  without  opening  the  cavity  where  the 
water  is  contained,  as  in  sinuous  ulcers.  This  I 
have  done,  and  seen  done  several  times,  but  never 
thought  the  cure  worth  the  trouble  and  pain  the 
patient  underwent.  The  true  hernia  aquosa  is  from 
the  abdomen5  which  cither  extends  the  peritonaeum 
into  the  scrotum,  or  breaks  it,  and  then  forms  a 
new  membrane  which  thickens  as  it  extends,  as  in 
aneurisms  and  atheromatous  tumors.  This  may 
be  decided  by  an  injection,  which  will  shew  by  the 
arteries  that  nourish  it,  whether  it  is  a production 
from  the  peritonaeum,  or  a new  membranous  bag 
formed  in  the  scrotum : however,  the  dropsy  in 
this  cist,  for  such  it  properly  is,  rarely  admits  of 
more  than  a palliative  cure  by  puncture  or  tapping, 
like  the  dropsy  of  the  abdomen,  and  this  with  some 
difficulty,  because  the  omentum  usually,  and  some- 
times the  gut,  descends  with  it.  The  other  proper 
coat  is  the  albuginea,  which  is  very  strong,  imme- 
diately enclosing  the  testicles.  The  testicles  of  a rat 
may  be  unravelled  into  distinct  vessels ; and  the  tex- 
ture of  the  testicles  of  other  animals  appear  to  be 
the  same,  but  their  vessels  are  too  tender,  or  co- 
here too  much  to  be  so  separated.  The  testicles 
receive  each  one  artery  from  the  aorta,  a little  be- 
low the  emulgents,  which,  unlike  all  other  arte- 
ries, arise  small,  and  dilate  in  their  progress,  that 
the  velocity  of  the  blood  may  be  sufficiently  abated 
for  the  secretion  of  so  viscid  a fluid  as  the  seed.  The 
right  testicle  returns  its  vein  into  the  cava,  and  the 


ifARTS  OR  ME#.' 


26$ 

loft  into  the  emulgent  vein  on  the  same  side,  both 
because  it  is  the  readiest  course,  and  because,  as  au- 
thors say,  this  spermatic  vein  would  have  been  ob^ 
structed  by  the  pulse  of  the  aorta,  if  it  had  crossed 
that  vessel  to  go  to  the  cava. 

A gentleman,  whom  I castrated  many  years 
since,  who  trusted  too  much  to  his  own  resolution, 
and  refusing  to  have  any  one  present  to  hold  him, 
except  my  assistant,  during. the  operation,  moved 
so  much,  that  the  ligature  which  tied  all  the  vessels 
with  the  procees  together,  slipt,  and  only  tied  the 
process  over  the  ends  of  the  vessels : which  being 
perceived  soon  after  the  operation,  I cut  the  liga- 
ture, and  took  out  the  extravasated  blood,  and  tied 
the  artery  alone,  which  gave  but  little  pain,  and  it 
digested  off  in  a week’s  time,  and  the  wound  being, 
afterwards  stitched,  though  the  testicle  weighed  a 
pound,  it  was  perfectly  well  in  five  weeks  ; which 
is  in  less  time  than  the  ligature  sometimes  requires 
to  be  digested  off,  when  the  process  and  all  the 
vessels  are  tied  together.  However,  if  this  case  is 
not  sufficient  to  recommend  doing  this  operation 
■by  tying  the  artery  only,  it  may  be  sufficient  to 
recommend  extraordinary  care  in  doing  of  it  die 
usual  way : for  if  the  blood  had  found  an  easy 
passage  into  the  abdomen,  the  patient  might  have 
bled  to  death. 

On  the  upper  part  of  the  testicles,  are  hard 
bodies  called  epididymi  ; which  are  evidently  the 
beginning  of  the  vasa  deferentia.  I have  uft- 
iA 


26G 


urinary  and  genital 


ravelled  them  backward,  in  single  vessels,  and  then* 
into-  more  and  smaller,  like  the  excretory  vessels 
of  other  glands. 

Vasa  deferentia  are  excretory  ducts  to  carry  the 
elaborated  seed  into  the  vesiculse  seminales.  They 
pass  from  the  epididymi  of  the  testicles,  together 
with  the  blood  vessels,  till  they  have  entered  the 
muscles  of  the  abdomen,  and  then  they  pass  under 
the  peritonaeum,  directly  through  the  pelvis,  to 
the  vesiculse  seminales. 

Vesicuke  seminales  are  two  bodies  that  appear 
like  vesicles  ; they  are  seated  under  the  bladder  of 
urine,  near  its  neck  ; they  may  be  each  of  them 
unfolded  into  one  single  duct,  which  discharges 
into  the  urethra,  by  the  sides  of  the  rostrum  gab 
linaginis,  which  is  an  eminence  in  the  under  side 
of  the  urethra  near  the  neck  of  the  bladder.  In 
these  vesicles,  or  ducts,  the  seed  is  reposited 
against  the  time  of  coition  ; but  in  dogs  there  are 
no  such  vesicles,  therefore  nature  has  contrived  a 
large  bulb  in  their  penis,  which  keeps  them  coup- 
led, seemingly  against  their  inclinations  till  the 
seed  can  arrive  from  the  testicles.  The  seed  passes 
from  these  vesicles  in  men,  and  even  from  the  vasa 
deferentia,  in  time  of  coition,  through  the  prostate 
glands  into  the  urethra,  as  in  those  animals  that 
have  no  vesiculce  seminales  ; for  when  the  ducts 
into  the  urethra  are  distended,  that  is  the  direct 
course  from  the  vasa  deferentia,  as  well  from 
the  vesiculte  seminales. 


PARTS  OF  MEN. 


267 


Prostats  are  two  glands,  or  rather  one,  about 
the  size  of  a nutmeg  : they  lie  between  the 
vesiculse  seminales  and  penis,  under  the  ossa  pubis, 
almost  within,  the  pelvis  of  the  abdomen.  They 
separate  a limpid  glutinous  humour  which  is 
carried  into  the  urethra  by  several  ducts,  which  en- 
ter near  those  of  the  prostats.  This  iiquor  seems 
to  be  designed  to  be  mixed  with  the  seed  in  the 
urethra,  in  the  time  of  coition,  to  make  it  flow 
more  easily.  If  the  venereal  infection  reaches  the 
prostate  glands,  it  will  sometimes  make  large  ab- 
scesses, which  are  apt  to  form  sinuses,  and  even 
make  a passage  into  the  bladder.  Upon  the  first 
attack  of  this  disease,  I have  prevented  all  this 
mischief,  by  taking  off  the  external  skin  by  in- 
cision, as  far  as  the  hardness  of  the  tumour  ex- 
tended, which  draining  very  plentifully,  the  tumour 
has  subsided,  and  the  patient  been  easily  cured  ; but 
this  case  once  becoming  fistulous,  is  very  difficult 
indeed.  It  often  is  cured  by  opening  the  sinuses 
and  consuming  the  diseased  parts  by  escarotics  : but 
a much  better  and  easier  way,  which  I have  often 
done,  is  to  cut  out  all  the  fistulous  and  diseased  parts 
at  once. 

Penis  ; its  shape,  situation,  and  use,  need  r.o 
description.  It  begins  with  two  bodies  named 
crura,  from  the  ossa  ischia,  which  unite  under 
the  ossa  pubis,  and  are  there  strongly  connected 
by  a ligament.  In  its  under  part  is  the  urethra, 
through  which  both  the  seed  and  urine  pass ; its 


268 


URINARY  AND  GENITAL 


fore  part  is  called  glans,  the  loose  skin  which  cov- 
ers it  praeputium,  and  the  straight  part  of  that  skin 
on  the  under  side,  fraenum.  The  urethra  is  lined 
with  a membrane  filled  with  small  glands  that 
separate  a mucus,  that  defends  it  against  the  acri- 
mony of  the  urine.  These  glands  are  largest  near- 
est the  bladder.  Mr.  Cowper.  describes  three  large 
glands  of  the  urethra,  which  he  discovered  ; two 
of  which  are  seated  on  the  sides  of  the  urethra 
near  the  ends  of  the  crura  penis  ; to  which  he 
adds  a third,  less  than  the  other,  seated  almost  in 
the  urethra,  a little  nearer  the  glans  than  the  for- 
mer. All  these  glands  have  excretory  ducts  into 
the  urethra,  and  from  them  are  secreted  all  the 
matter  which  flows  from  the  urethra  in  a gonor- 
rhcea,  whether  venereal  or  not.  In  the  venereal 
infection,  the  urethra  and  the  glands  are  'first  in- 
flamed by  the  contagious  matter,  that  causes  a heat 
of  urine,  which  abates  as  soon  as  the  glands  begin 
to  discharge  freely  $ but  if  by  chance  this  disease 
continues  till  any  part  of  the  urethra  is  ulcerated  ; 
the  ulcer  never  heals  without  a cicatrix,  which 
constricts  the  urethra,  and  makes  that  disease 
which  is  vulgarly  called  a caruncle.  The  inner 
texture  of  the  penis  is  spongy,  like  the  inner  tex- 
ture of  the  spleen,  or  the  ends  of  the  great  bones, 
ft  is  usually  distinguished  into  corpus  cavernosum 
penis,  glandis,  and  urethrae.  The  first  of  these 
makes  part  of  the  glans,  and  is  divided  its  whole 
length  by  a septuin  $ the  other  two  are  composed 


FARTS  OF  MEW. 


269 

■ 

of  smaller  cells,  and  are  but  one  body.  On  the 
tipper  side  of  the  penis  are  two  arteries,  and  one 
vein  called  vena  ipsius  penis.  The  arteries  are  de- 
rived from  the  beginnings  of  the  umbilical  arteries, 
which  parts  never  dry  up,  and  the  vein  runs  back 
-to  the  iliac  veins.  The  vena  ipsius  penis,  being 
obstructed,  the  blood  that  comes  by  the  arteries, 
distends  the  cells  of  the  whole  penis,  and  makes 
it  erect ; but  to  prevent  mischief  from  this  me- 
chanism, there  are  small  collateral  veins  on  the  sur- 
face of  the  penis,  that  carry  back  some  blood  all 
the  time  the  penis  is  erect  *,  but  by  what  power 
the  vena  ipsius  penis  is  obstructed  to  erect  the 
penis,  I cannot  conceive,  unless  small  muscular 
fibres  constrict  it.  Some  think  the  musculi  erec- 
tores  penis  do  it,  by  thrusting  the  penis  against 
the  os  pubis ; but  they  seem  not  seated  conve- 
niently for  such  an  office  ; besides,  if  a pressure 
from  the  lower  side  of  the  penis  is  sufficient,  an 
artificial  pressure,  which  may  be  much  greater, 
should,  I think,  produce  the  same  effect. 

In  the  seed  of  men,  and  of  other  male  animals, 
Lewenhoeck,  by  the  help  of  microscopes,  dis- 
covered an  infinite  number  of  animals  like  tad- 
poles, which  he  and  others  suppose  to  be  men  in 
miniature,  and  that  one  of  these  being  entered 
into  an  egg  in  one  of  the  ovaria  (see  the  next 
chapter)  conception  is  performed.  But  though 
scarce  any  one,  that  has  made  due  inquiry,  has 
ever  doubted  of  -the  existence  of  these  animals. 


270 


URINARY  AND  GENITAL 


yet  there  are  many  who  object  against  this  hypoth- 
esis ; and  though  I am  inclined  to  think  it  true, 
yet  I will  endeavour  impartially  to  lay  down  the 
principal  objections  and  answers,  that  the  reader 
may  judge  for  himself.  The  first  and  strongest 
objection,  is  raised  from  the  several  instances  that 
have  happened  of  mixed  generation,  where  the 
animal  produced  always  appears  to  partake  of  both 
kinds,  as  in  the  common  case  of  a mule,  which 
is  begot  by  an  ass  upon  a mare  ; when,  according 
to  that  hypothesis,  they  expect  the  animal  pro- 
duced frOm  mixed  generation  should  be  entirely 
of  the  same  species  with  the  male  animal ; as  the 
seeds  of  plants,  whatever  earth  they  grow  in,  al- 
ways produce  plants  of  the  same  kind.  Never- 
theless, if  we  consider  what  influence  women’s 
fears  or  longings  frequently  have  upon  their  chil-  j 
dren  in  utero,  and  how  great  a change  castration  | 
makes  in  the  shape  of  any  animal,  we  cannot 
then  wonder  if  the  mother’s  blood,  to  which  the  ! 
animal  owes  its  nourishment  and  increase,  from 
the  time  of  impregnation  to  the  time  of  its  birth, 
should  be  thought  a sufficient  cause  of  resemblance  i 
between  these  animals  and  their  mothers.  Anoth- 
er objection  is,  that  nature  should  provide  such 
a multiplicity  of  these  animals,  when  so  few  can  . 
ever  be  of  use.  To  which  it  has  been  answered, 
that  in  plants  a very  few  of  the  whole  that  are 
produced,  fall  into  the  earth,  and  produce  plants  ; j 
and  as  in  plants  the  greatest  part  of  their  seeds 


PARTS  or  he5t« 


271 


are  the  food  of  animals,  so  the  greatest  part  of 
the  animalcule  may  as  well  live  a time  to  enjoy 
their  own  existence,  as  any  other  animal  of  as  Iow- 
an order.  The  last  objection  is  their  shape,  which 
I think  will  appear  to  have  no  great  weight, 
when  we  consider  hove  the  eggs  of  flies  produce 
maggots,  which  grow  up  into  flies  ; and  the  tad- 
pole produced  from  the  egg  of  a frog,  grows  into 
a form  as  different  from  a tadpole  as  the  form  of 
a man  : and  if  these  animals  had  produced  so  few 
at  a time,  as  that  their  young  might  have  under- 
gone this  change  in  utero,  it  is  highly  probable, 
that  we  should  not  so  much  as  have  suspected  these 
analogous  changes.  But  how  the  animal culse 
themselves  are  produced,  is  a difficult  question. 
Tinless  by  equivocal  generation,  seeing  none  of 
them  appear  to  be  in  a state  of  increase,  but  all 
of  a size. 

In  a boy  that  died  of  the  stone,  I found  a 
double  ureter,  each  part  being  dilated  to  an  inch 
diameter ; the  pelvis  in  each  kidney  to  twice  its 
natural  bigness,  and  the  tubuli  urinarii,  each  as 
large  as  the  pelvis. 

In  a man  that  had  never  been  cut  for  the  stone, 
I found  the  ureters  dilated  in  some  places  to  four 
inches  circumference,  and  in  others  but  little  dilat- 
ed, and  a stone  that  I found  in  the  bladder  was 
less  than  a nutmeg,  which  must  have  fallen  in  sev- 
eral pieces,  or  both  ureters  could  not  have  been 
dilated.  From  this,  and  other  like  observations^ 


272  genital  parts  Of  WomenV 

I think  it  appears,  that  the  great  size  to  which: 
the  ureters  are  usually  extended,  in  people  who 
are  troubled  with  the  stone,  is  owing  to  small 
stones  which  stick  at  the  entrance  into  the  blad- 
der, until  the  obstructed  urine,  which  dilates  the 
ureters,  can  force  them  into  the  bladder. 

I have  in  several  subjects  found  one  kidney  al- 
most consumed,  and  once  a man  with  but  one  kid-< 
ney  ; and  I have  seen  lymphatics  in  a diseased 
testicle,  as  large  as  a crow  quill. 


CHAPTER  II. 

Jf  the  genital  parts  Of  women. 

The  external  parts  are  the  mons  veneris,  which' 
is  that  rising  of  fat  covered  with  hair  above  the 
rima  magna  upon  the  os  pubis,  the  great  doub- 
ling of  the  skin  on  each  side  the  rima  called  labia, 
and  within  these  a lesser  doubling  named  nymphae. 
These  help  to  close  up  the  orifice  of  the  vagi- 
na. The  nymphae  are  usually  said  to  serve  to  de- 
fend the  labia  from  the  urine  ; but  I do  not  see 
how  the  labia  stand  more  in  need  of  such  a de- 
fence, than  the  nymphae  themselves. 

Clitoris  is  a small  spongy  body,  bearing 
some  analogy  to  the  penis  in  men,  but  has  no 
urethra.  It  begins  with  two  crura  from  the  ossa 
ischia,  which  uniting  under  the  ossa  pubis,  it 


GENITAL  PARTS  OF  WOMEN,  273 

proceeds  to  the  upper  part  of  the  nymphte,  where 
it  ends  under  a small  doubling  of  skin,  called  prse» 
putium  ; and  the  end  which  is  thus  covered  is  call- 
ed glans.  This  is  said  to  be  the  chief  seat  of 
pleasure  in  coition,  in  women,  as  the  glans  is  in 
men. 

A little  lower  than  this,  just  within  the  vagina, 
is  the  exit  of  the  meatus  urinarius. 

Vagina  is  seated  between  the  bladder  of  urine 
and  the  intestinum  rectum.  The  texture  of  it 
is  membranous,  and  its  orifice  is  contracted  with 
a sphincter  (vid.  muse,  sphincter  vaginae)  but  the 
farther  part  is  capacious  enough  to  contain  the  pe- 
nis without  dilating.  Near  the  beffinnin^  of  the 
vagina,  immediately  behind  the  orifice  of  the  me- 
atus urinarius,  is  constantly  found  in  children  a> 
valve  called  hymen,  which,  looking  towards  the 
orifice  of  the  vagina,  closes  it  ; but  as  children 
grow  up,  and  the  sphincter  vaginas  grows  strong 
enough  to  contract  and  close  the  orifice  of  the 
vagina,  this  valve  becoming  useless,  ceases  to  in- 

! crease,  and  is  then  known  by  the  name  of  carun- 
culae  myrtiformes.  There  have  been  a few  instan- 
ces in  which  the  edges  of  this  growing  together,  it 
continued  unperforate,  until  it  has  been  necessary 
to  make  an  incision  to  let  out  the  menses.  The 
inner  part  of  the  vagina  is  formed  into  rugae, 
which  are  largest  in  those  who  have  not  used  cop- 
ulation 5 and  least  in  those  who  have  had  many 
children.  Under  these  rugae  are  small  glands, 


m m 


2T4  GENITAL  PARTS  OT  WOMEN. 

whose  excretory  ducts  are  called  lacunae  : these 
glands  separate  a mucilaginous  matter  to  lubricate 
the  vagina,  especially  in  coition  : and  are  the  seat 
of  a gonorrhoea  in  this  sex,  as  the  glands  in  the  u- 
rethra  are  in  the  male. 

Uterus  is  seated  at  the  end  of  the  vagina ; it 
is  about  one  inch  thick,  two  broad,  and  large, 
enough  to  contain  the  kernel  of  a hazel  nut ; but 
th  women  that  have  had  children,  a little  larger. 
Its  orifice  into  the  vagina  is  called  os  tincae,  from 
the  resemblance  it  bears  to  a tench’s  mouth.  It 
has  two  round  ligaments  which  go  from  the  sides 
of  it  to  the  groins  through  the  oblique  and  trans- 
verse muscles  of  the  abdomen,  in  the  same  man- 
ner as  do  the  seminal  vessels  in  men.  This  way 
the  gut  passes  in  a hernia  int'estinalis  in  women 
(vid.  musculi  abdominis.)  Some  authors  mention 
ligamenta  lata,  which  are  nothing  but  a part  of 
the  peritonxum.  Near  the  sides  of  the  uterus  lie 
two  bodies  called  ovaria  ; they  are  of  a depressed 
oval  figure,  about  half  the  size  of  men’s  testicles, 
and  have  spermatic  vessels  ; they  contain  small  pel- 
lucid eggs,  from  which  they  have  their  name. 
There  are  twO  arteries  and  two  veins,  which  pass 
to  and  from  the  ovaries  or  testes,  in  the  same 
manner  that  they  do  in  men  ; but  make  more 
windings,  and  the  arteries  dilate  more  suddenly, 
in  proportion  as  they  are  shorter.  These  arteries 
and  veins  detach  branches  into  the  uterus  and  fal- 
lopian tubes,  and  not  only  make  communications' 


■GENITAL  PARTS  OF  WOMEN. 


275 


ifeetwixt  the  artery  and  vein  on  one  side  and  those 
of  the  other,  but  also  with  the  proper  vessels  of  the 
uterus,  which  are  detached  from  the  internal  iliac 
arteries  and  veins.  From  these  vessels  in  the  in- 
side of  the  uterus,  the  menstrual  purgations  are 
made  in  women,  and  something  of  the  same  kind 
in  brutes,  as  often  as  they  desire  coition.  One  use 
of  these  purgations  is,  to  open  the  vessels  of  the 
uterus,  for  the  vessels  of  the  placenta  to  join  to 
them.  Many  authors  have  imagined,  that  there 
must  be  some  evacuations  analogous  to  this,  in 
men,  which  I cannot  see  the  necessity  of ; but, 
on  the  contrary,  I believe  that  men’s  not  having 
such  evacuations,  is  the  true  reason  why  their  bod- 
ies grow  larger  and  stronger  than  women’s : and 
their  continuing  to  grow  longer  before  they  are  fit 
for  marriage,  I also  take  to  be  the  true  reason  why 
there  are  more  males  born  than  females,  in  about 
the  proportion  of  thirteen  to  twelve  ; for  women 
being  sooner  fit  for  marriage  than  men,  fewer  will 
die  before  that  time,  than  of  men. 

Near  the  sides  of  the  ovaria  are  seated  the  tu- 
bse  fallopianx,  one  end  of  which  is  connected  to  the 
uterus  and  the  side  of  the  ovarium  by  a mem- 
brane, the  other  end  is  loose,  and  being  jagged  is 
called  morsus  diaboli.  Among  these  jags  is  a 
small  orifice  which  leads  into  the  tube,  which 
near  this  end  is  about  a quarter  of  an  inch  diame- 
ter, and  thence,  growing  gradually  smaller,  passes 
to  the  uterus,  and  enters  there  with  an  orifice 


276  GENITAL  PARTS  OP  WOMEN. 

about  the  size  of  a hog’s  bristle.  The  use  of  these 
tubes  is  to  convey  the  male  seed  from  the  uterus  to 
the  ovaria,  to  impregnate  the  eggs  for  conceptions  ; 
yet  they  appear  so  ill  adapted  to  this  end,  that 
many  have  supposed  there  must  be  some  other 
passage  from  the  uterus  to  the  ovaria : but  when 
we  consider  the  case  of  conceptions  found  in  these 
tubes,  and  the  exact  analogy  between  these  and 
the  tubes  of  birds,  where  we  have  the  most  un- 
deniable proofs  of  the  seed  going  through  the 
tube,  and  of  the  eggs  being  impregnated  that  way, 
and  of  the  eggs  coming  from  the  ovarium  through 
the  tube,  and  seemingly  with  much  greater  dif- 
ficulty than  in  women  ; and  besides,  how  fre- 
quently a matter  like  the  male  seed  (which  I sup- 
pose is  seed)  is  found  in  the  fallopian  tubes  of 
women,  as  I have  found  in  executed  bodies,  and  in 
a common  whore  that  died  suddenly,  it  appears 
to  me  almost  certain,  that  the  seed  goes  through 
the  fallopian  tubes  to  the  ovaria  to  impregnate 
eggs,  and  comes  back  through  the  same  tubes  to 
the  uterus.  I have  seen  in  a woman  both  the  fal- 
lopian tubes  unperforated,  which,  upon  the  fore- 
going hypothesis,  must  have  caused  barrenness, 
and  seed  lodged  in  these  tubes  may  have  the  same 
effect  ; which  I take  to  be  often  the  case  of  com- 
mon whores,  and  women  that  use  coition  too  fre- 
quently ; and  perhaps  the  fat  in  the  membrane 
that  connects  the  ovaria  to  the  tubes,  may  in  very 
fat  women  so  keep  these  tubes  from  the  ovaria  as 


GENITAL  PARTS  OF  WOMEN. 


277 


to  interrupt  impregnations  ; and  besides  these 
cases,  too  much  or  too  little  of  the  menses  may 
destroy  or  interrupt  conceptions  ; but  the  latter 
case,  especially  in  young  women,  is  very  rare. 
From  such  causes  as  these,  and  not  from  imbecil- 
ity, I imagine  it  is  that  barrenness  oftener  pro- 
ceeds from  women  than  men  ; and  though  women 
do  not  propagate  to  so  great  an  age  as  men,  it  is 
not,  I believe,  for  waat  of  being  impregnated, 
but  from  their  menses  ceasing,  and  those  vessels 
being  closed  which  should  nourish  the  foetus  after 
the  impregnation,  as  if  on  purpose  to  prevent  the 
propagation  of  a feeble  and  infirm  species.  And 
from  this  consideration,  one  cannot  but  think  that 
the  perfection  of  the  foetus,  notwithstanding  it  is 
first  formed  in  the  male  seed,  depends  more  upon 
the  female  than  the  male ; or  else  that  nature 
would,  for  the  sake  of  the  species,  have  been  careful 
to  hinder  men  as  well  as  women  from  propagating 
in  a declining  age. 


275 


FOETUS  IK  UTERO. 


CHAPTER  III. 

OF  THE  FOETUS  IN  UTERO. 

The  foetus  in  utero  is  involved  in  two  coats, 
viz.  chorion,  which  is  external,  and  amnion,  which 
immediately  encloses  the  foetus.  They  contain  a 
quantity  of  liquor,  which  is  a proper  medium  for 
so  tender  a being  as  the  foetus  to  rest  in,  and  part- 
ly secures  it  from  external  injuries,  as  the  aqueous 
humour  does  the  crystalline  in  the  eye  \ and  when 
the  membranes  burst  at  the  time  of  production, 
this  humour  lubricates  the  vagina  uteri,  to  ren- 
der the  birth  less  difficult.  And  seeing  the  stom- 
ach of  a foetus  in  utero  is  always  full  of  a fluid, 
like  what  is  contained  in  the  amnion,  and  the 
guts  not  without  excrements  ; we  may  suppose 
that  this  fluid  is  frequently,  during  the  time  of 
gestation,  swallowed  by  the  foetus,  if  not  for  nour- 
ishment, at  least  to  keep  these  parts  in  use,  and  to 
flow  through  the  lacteals,  as  a quantity  of  blood 
from  the  right  ventricle  of  the  heart  flows  through 
the  lungs  before  the  birth  to  keep  open  those  pas- 
sages till  the  birth,  there  being  after  that  time  no 
other  way  of  receiving  nourishment,  and  that  the 
faeces  found  in  the  guts  of  a foetus  are  those  parts 
of  this  fluid  that  were  taken  in  at  the  mouth, 
and  were  too  gross  to  enter  the  lacteals.  Yet  I 
own  it  takes  off  very  much  from  the  probabil- 
ity of  the  opinion  of  the  foetus’s  imbibing  this 


TOETUS  IN  UTERO. 


279 


liquor,  that,  if  I am  rightly  informed,  some  who 
have  been  born  with  mouths  and  nostrils  unper- 
forate,  have  had  such  fluids  and  excrements  in  the 
intestines  that  other  foetus’s  have,  which  must  be 
confessed,  may  be  derived  from  the  salivary  glands' 
and  from  the  liver,  &c.  The  following  curious 
passage  was  sent  me  by  Mr.  Monro.  “ This  li- 
44  quor  contributes  nothing  to  the  nourishment  of 
44  the  foetus,  for  these  reasons  ; first,  because,  as 
44  you  have  well  observed,  vast  numbers  of  in- 
44  stances  might  be  produced,  where  no  passage 
44  w’as  to  be  found  for  it  : I shall  give  you  one  I 
44  saw  myself  in  the  Hotel  de  Dieu  at  Paris,  in 
4r  1718. 

44  Mary  Guerlin  brought  forth  two  children, 
44  one  a complete  girl,  the  other  had  neither  head, 
44  neck,  arms,  heart,  lungs,  stomach,  small  guts,- 
44  liver,  spleen,  or  pancreas,  yet  the  great  guts, 
44  the  organs  of  urine  and  generation  of  a female, 
44  and  lower  extremities  were  perfect,  and  of  a na- 
44  tural  growth  ; the  umbilical  vein,  after  entering 
44  the  abdomen,  split  into  a great  many  branches, 
44  which  were  distributed  to  the  several  parts  in 
44  its  abdomen.  Though  it  is  true  that  soon  af- 
44  ter  conception,  the  liquor  in  the  amnion,  and 
44  that  in  the  stomach  of  the  foetus  resemble  one 
44  another  pretty  near,  yet  afterward  they  differ 
44  exceedingly  ; for  the  liquor  in  the  stomach  is 
44  still  gelatinous,  thick,  and  without  acrimony, 
44  while  the  other  becomes  thinner  and  more  acrid  ;■ 


280 


foetus  in  utero. 


<e  whereas,  had  the  foetus  constantly  swallowed 
4C  this  liquor,  the  case  would  have  been  quite  op- 
“ posite  ; nay,  often  it  has  happened  that  these 
<c  waters  (as  they  are  commonly  called)  have  been 
“ found  quite  corrupted,  strongly  fetid,  and  ex- 
44  tremely  sharp,  while  the  foetus,  except  the  in- 
44  juries  which  the  external  parts  received,  was 
44  well  and  sound  ; witness  the  example  mentioned 
“ by  Bellinger,  of  a woman  who  was  cured  of 
44  a virulent  gonorrhoea  during  her  going  with 
44  child.  And  farther,  by  Malpighius’s  delinea- 
44  tions  of  the  pullus  in  ovo,  it  appears  to  be  evi- 
44  dent  that  the  asitellus  serves  the  same  purpose  as 
44  the  placenta  does  in  viviparous  animals,  to  con- 
44  vey  the  albumen  attenuated  by  incubation  into 
44  the  blood  vessels  of  the  chick,  and  that  none  of 
44  the  albumen  does  pass  through  the  saccus  colli- 
54  quamentid’ 

Besides  these  coats,  in  a cow  and  many  other  ani- 
mals, we  find  a membrane  called  alantois  ; it  is  en- 
closed by  the  chorion  together  with  the  amnion, 
and  contains  a quantity  of  water  which  it  receives 
from  the  bladder  of  urine  by  the  urachus.  Its  use 
seems  to  be  to  contain  the  urine,  that  it  might  not 
by  the  common  passage  be  emptied  into  the  liquor 
of  the  amnion,  of  which  the  foetus,  I am  inclined  to 
think,  is  frequently  drinking. 

Whether  an  alantois  is  to  be  found  with  a hu- 
man fetus  or  no,  anatomists  are  not  agreed,  and 
I cannot  give  my  opinion,  having  never  had  a 


281 


FOETUS  IN  UTERO. 

sufficient  opportunity  to  inquire.  But  surely  chil- 
dren having  an  urachus,  one  cannot  well  doubt  of 
an  alantois.  I have  been  informed  by  a gentleman, 
who-se  probity  I can  sufficiently  rely  on,  that  he 
had  seen  a child  that  had  no  external  genital  parts, 
and  made  water  through  the  navel.  At  Henley 
upon  Thames,  there  is  now  living  a bargeman’s 
child  about  ten  years  old,  of  which  I had  the  like 
account ; but  upon  examination  I found  the  un- 
perforated glans  with  its  fraenum  immediately  be- 
low the  place  of  the  navel,  and  the  urine  issued 
out  by  drops  between  this  and  the  belly,  in  the 
place  which  I suppose  was  the  navel,  but  it  was 
so  much  excoriated,  that  I could  make  no  certain 
judgment  about  it.  In  the  uterus  of  a cow  with 
two  calves,  I found  they  had  but  one  chorion, 
but  each  an  amnion  and  alantois  distinct ; but  the 
cotyledons,  which  are  analogous  to  the  placenta  of 
the  human  foetus,  were  pretty  much  in  common  to 
the  umbilical  blood  vessels  of  both. 

The  placenta,  or  womb-liver,  is  a mass  of 
blood  vessels  seated  on  the  outside  of  the  chorion, 
being  composed  of  the  extreme  branches  of  the 
umbilical  vein  and  arteries,  which  are,  for  the 
composition  of  this  part,  divided  into  exceeding 
small  branches,  to  join  a like  number  of  the  men- 
strual vessels  of  the  uterus ; which  vessels  of  the 
uterus  are  made  numerous  rather  than  large,  that 
the  separation  of  the  placenta  from  them  may  not 
be  attended  with  a flux  of  blood  fatal  to  the  mo- 


n n 


2&2  lO'ETUS  IN  UTEftO» 

ther ; for  the  sides  of  little  vessels  soon  collapse 
and  dose,  and  they  are  more  easily  stopped,  being 
compressed  by  the  uterus  itself  as  it  shrinks,  which 
it  begins  to  do  from  the  time  of  the  birth  ; but 
when  the  placenta  is  separated  before  the  delivery, 
whether  untimely  or  not,  these  vessels  bleed  until 
the  uterus  is  discharged  of  the  foetus.  The  figure 
of  the  placenta  is  circular,  and  at  its  greatest 
growth  about  two  inches  thick,  and  six  or  seven 
in  diameter. 

The  arteries  and  veins  of  the  uterus  of  the  mo^ 
ther,  by  which  the  menstrual  purgations  are  made*- 
are  joined  to  the  umbilical  arteries  and  veins  in  the 
placenta  of  the  foetus,  the  arteries  of  the  uterus  ta 
the  veins  in  the  placenta,  and  the  veins  in  the 
uterus  to  the  arteries  of  the  placenta  : by  these 
vessels  a large  quantity  of  blood  is  continually 
ilowing  from  the  mother  to  the  foetus  and  back 
again  ; but  for  what  end  such  a quantity  flows 
continually,  and  back  again,  I cannot  conceive* 
Unless  it  is  that  the  foetus  not  breathing  for  itself, 
it  is  necessary  that  as  much  blood  of  the  mother 
should  flow  continually  to  the  foetus,  as  can  leave 
enough  of  air,  or  whatever  our  blood  receives  in 
the  lungs,  for  the  foetus ; and  perhaps  what  nutri- 
tious juices  the  foetus  receives,  require  a great  deal 
of  olood  to  convey  them,  they  being  but  a small 
part  of  the  blood.  And  though  the  blood  passes- 
so  plentifully  between  the  mother  and  the  foetus, 
yet  the  communications  are  not  so  obvious  as  they 


FOETUS  IN  UTERO.  233 

mtt  between  the  arteries  and  veins  in  the  same 
body  ; which  makes  some  think  the  communica- 
tion is  not  made  by  inosculations  of  vessels,  but  that 
the  foetus  is  nourished  from  the  placenta  in  a vege- 
table manner  ; but,  I own,  I am  not  of  this  opin- 
ion. The  navel  string  or  umbilical  blood  vessels, 
between  the  placenta  and  the  navel,  are  about  two 
feet  long,  that  the  foetus  may  have  room  to  move 
without  tearing  the  placenta  from  the  uterus, 
which  being  done  too  soon,  from  whatever  cause, 
occasions  a miscarriage.  These  vessels,  viz.  two 
arteries  and  one  vein,  twist  about  each  other,  par- 
ticularly the  arteries  about  the  vein,  and  are  con- 
tained in  one  common  coat  together  with  a vessel 
called  urachus,  which  arises  from  the  top  of  the 
bladder  of  urine,  and  ends  in  the  membrana  alan- 
tois ; the  umbilical  vein  goes  from  the  navel  di- 
rectly into  the  liver,  and  there  enters  the  great 
trunk  of  the  vena  portae.  Near  which  entrance 
there  goes  out  the  ductus  venosus  to  the  great 
trunk  of  the  cava,  which  carries  part  of  the  blood 
that  is  brought  by  the  umbilical  vein,  that  way 
into  the  cava,  while  the  rest  circulates  with  the 
blood  in  the  porta,  the  whole  of  it  not  passing 
through  the  ductus  venosus,  as  is  generally  believed, 
but  a great  part  of  it  into  branches  of  the  porta, 
in  the  liver,  otherwise  there  need  be  no  commu- 
nication between  the  umbilical  vein  and  the  porta. 
When  the  umbilical  vein  is  stopped,  it  becomes 
a ligament,  and  the  ductus  venosus  soon  shrinks 


284  FOETUS  IN  UTER©. 

and  almost  disappears,  having  no  longer  any  blood 
flowing  through  it  ; and  even  the  porta  itself 
within  the  liver,  from  whence  only  blood  could 
pass  after  the  birth  into  the  ductus  venosus,  has 
less  blood  flowing  through  it  for  some  time  than 
it  had  before  the  birth,  it  receiving  much  blood 
before  the  birth  from  the  umbilical  vein.  The 
blood  which  flows  from  the  mother  to  the  foetus 
by  the  umbilical  vein,  is  returned,  all  but  a small 
quantity,  which  is  reserved  for  nutrition  by  the 
two  umbilical  arteries,  which  arise  from  the  inter- 
nal iliac  arteries,  and  passing  by  the  outsides  of 
the  bladder  go  directly  to  the  navel,  and  placen- 
ta ; these  with  the  urachus  being  shrunk  up  after 
the  birth,  lose  much  of  their  appearance,  especially 
near  the  navel,  where  they  are  sometimes  not  to 
be  distinguished. 

Part  of  the  blood  before  the  birth,  and  not  the 
whole  quantity,  as  is  generally  thought,  which  is 
brought  by  the  ascending  cava  to  the  right  auri- 
cle, passes  at  once  through  the  foramen  ovale  into 
the  left  auricle,  and  the  rest  flows  into  the  right 
ventricle  with  the  blood  of  the  descending  cava, 
and  thence  into  the  pulmonary  artery,  where  about 
one  half  flows  into  the  lungs,  and  the  other  half 
directly  into  the  aorta  by  the  ductus  arteriosus, 
which  lies  between  the  pulmonary  artery  and  the 
aorta,  which  after  the  birth  is  called  ductus  ar- 
teriosus in  ligamentum  versus.  The  better  to  ex- 
plain this  contrivance,  I wall  call  the  quantity  of 


TOETUS  IN  UTERO. 


285 


blood  flowing  through  the  ascending  cava  in  a 
given  time,  four  ; and  that  which  flows  through 
the  descending  cava,  two  : then  let  two  of  the 
quantity  in  the  ascending  cava  flow  into  the  right 
auricle,  it  will  then  with  the  two  received  from 
the  descending  cava  have  the  quantity  four  ; which 
being  thrown  from  the  right  ventricle  into  the 
pulmonary  artery,  the  quantity  two  is  thrown  into 
the  aorta  by  the  ductus  arteriosus,  and  the  same 
quantity  into  the  lungs  by  the  pulmonary  branches ; 
then  the  quantity  returning  from  the  lungs  to 
the  left  auricle,  will  be  two  in  the  same  given 
time,  which  being  added  to  the  two  which  flowed 
through  the  foramen  ovale,  in  the  same  time 
there  will  be  constantly  the  same  proportions  re- 
ceived into  each  ventricle,  at  every  diastole  of  the 
ventricles,  as  after  the  birth.  Now  if  the  blood, 
flowing  through  the  ascending  cava  joined  by  that 
from  the  umbilical  vein,  was  but  equal  to  that 
flowing  through  the  descending,  let  each  of  them 
be  called  two,  and  let  all  the  blood  of  the  ascend- 
ing cava  go  through  the  foramen  ovale  ; then  the 
blood  which  the  left  ventricle  would  receive, 
would  exceed  that  which  flows  into  the  right,  by 
the  whole  quantity  which  flows  from  the  lungs 
in  the  same  time  ; but  the  ascending  cava  convey- 
ing more  blood  than  the  descending  cava,  the  ex- 
cess in  the  left  ventricle  would  be  yet  greater.  If 
the  proportions,  which  I have  taken  for  the  easier 
computing,  were  perfectly  right,  as  I am  sure 


286 


FOETUS  IN  uteao. 


they  are  nearly,  then  the  quantity  flowing  into  the 
left  ventricle  would  be  to  that  flowing  into  the 
right  at  the  same  time  as  five  to  two,  if  all  the  as- 
cending blood  went  through  the  foramen  ovale* 

And  though  after  the  birth  the  left  ventricle  of 
the  heart  is  Only  employed  in  throwing  blood  into 
the  aorta,  and  the  right  wholly  employed  in  cir- 
culating the  blood  through  the  lungs ; yet  before 
the  birth,  all  the  blood  thrown  out  by  the  left  ven- 
tricle, and  about  half  the  blood  thrown  out  of 
the  right  ventricle,  being  thrown  into  the  aorta, 
and  the  other  part  only  through  the  lungs,  it  fol- 
lows, that  the  whole  force  exerted  by  the  left 
ventricle,  with  about  half  that  of  the  tight,  is 
employed  in  throwing  blood  into  the  aorta,  while 
that  distributes  blood  through  the  whole  foetus 
and  to  the  mother  : but  after  the  birth,  when  the 
blood  is  to  be  no  longer  carried  from  the  foetus 
to  the  mother,  the  left  ventricle  becomes  sufficient 
for  the  circulation  through  the  foetus,  and  a new 
occasion  immediately  arises  for  that  additional 
power,  which  before  was  necessarily  employed 
in  throwing  blood  into  the  aorta  : for  the  whole 
mass  of  blood  now  being  to  be  circulated  through 
the  lungs,  the  ductus  arteriosus  closes,  and  the 
right  ventricle  must  throw  all  the  blood  it  receives 
into  the  lungs,  there  being  no  longer  any  passage 
into  the  aorta.  It  is  supposed  that  the  inflation  of 
the  lungs  at  the  birth,  presently  alters  the  position 
of  the  ductus  arteriosus,  so  as  to  obstruct  it  ; which 


rOETtJS  IN  UTERCe  28 1 

account  is  indeed  mechanical,  but,  I think,  not 
true,  because  I can  neither  discern  that  the  position 
of  this  vessel  is.  altered,  nor  its  surface  compressed  : 
but  I rather  think  that  immediately  upon  the 
birth,  there  beino-  no  blood  carried  off  from  the 
foetus  to  the  mother,  and  the  left  ventricle  being 
sufficient  to  fill  the  aorta  and  its  branches  with 
blood,  as  I have  shewn  before,  there  is  no  longer 
room  for  any  blood  from  the  right  ventricle  ; 
wherefore  the  blood  from  the  right  ventricle  will 
be  forced  into  the  lungs,  where  the  passage  is 
now  made  easy,  as  I imagine,  by  their  being  in- 
flated ; and  the  ductus  arteriosus,  having  the  blood 
no  longer  forced  into  it,  shrinks,  and  in  time  al- 
most disappears.  This  duct  being  stopped,  the 
valve  of  the  foramen  ovale  soon  stops  that  passage, 
it  being  on  the  side  of  the  left  auricle  (or  that 
muscular  bag,  which  is  the  largest  part  of  that 
auricle)  which  being  much  the  strongest,  the  valve 
must  be  pressed  more  on  that  side  than  the  other, 
by  the  blood,  in  the  time  of  the  systole  of  the  au- 
ricle ; and  it  is  as  evident,  that  in  the  diastole  of 
the  auricle,  there  must  be  more  pressure  to  open 
that  than  the  right,  it  being  a stronger  muscle,  or 
else  there  could  have  been  no  reason  for  having 
the  left  auricle  stronger  than  the  right,  in  propor- 
tion to  their  ventricles.  Sometimes  this  valve  does 
not  quite  cover  the  foramen,  in  which  case  a small 
quantity  of  the  blood  may  possibly  Sow  from  the 
left  auricle  to  the  right,  and  so  circulate  twice 


288 


FOETUS  IN  UTERO. 


through  the  lungs  to  once  through  the  body,  blit 
none  could  flow  from  the  right  to  the  left  and 
escape  the  lungs,  which  might  be  of  bad  conse- 
quence. Some  have  imagined,  that  men,  who 
have  this  passage  open,  cannot  be  drowned  : but 
though  this  passage  is  sometimes  found  open,  no 
man  has  been  yet  seen,  that  we  have  ever  heard  of, 
that  could  not  be  drowned.  I have  seen  the  fo- 
ramen open  in  a man  that  was  hanged,  to  whom 
one  might  justly  expect  it  should  have  been  as  use- 
ful as  An  the  case  of  submersion  in  water.  Many 
writers  have  supposed,  that  this  foramen  is  open  in 
amphibious  animals,  and  in  such  fishes  as  have 
two  auricles,  two  ventricles,  and  lungs  like  land 
animals,  without  gills,  which  in  other  fish  are 
analogous  to  lungs.  I have  dissected  a porpoise, 
which  is  of  this  kind,  and  found  this  foramen 
closed,  but  the  great  veins  were  vastly  large  in  pro- 
portion to  the  bulk  of  the  animal  ; whence  I con- 
jectured, their  blood  was  accumulated  in  their 
veins,  while  they  kept  under  water,  and  by  that 
means  the  lungs  escaped  being  oppressed  with 
blood ; which  conjecture  seemed  to  me  the  more 
probable,  since  all  animals  of  this  kind  are  able  to 
abide  the  least  time  under  water,  when  their  blood 
is  most  expanded  with  heat.  But  upon  the  dis- 
section of  an  otter,  whose  foramen  ovale  was  also 
closed,  I found  the  veins  nothing  differing  from 
those  of  other  animals.  In  a water  tortoise,  which 
I had  an  opportunity  of  examining,  with  that 


FOETUS  IN  UTERO.  289 

most  dexterous  and  indefatigable  anatomist,  Dr. 
Douglas,  I found  the  two  ventricles  of  the 
heart  but  half  divided  by  a septum,  and  in  the 
beginning  of  the  pulmonary  artery  several  strong 
muscular  rings,  a little  distance  from  each  other, 
each  of  which,  by  contracting,  would  be  capable 
of  resisting  a part  of  that  blood  which  otherwise 
would  have  been  thrown  into  the  lungs,  when 
they  were  under  water  ; and  this  blood  so  ob- 
structed must  necessarily  be  thrown  into  the  aorta, 
the  two  ventricles  being;  in  a manner  one  com- 
mon  cavity  ; and  when  they  are  out  of  the  water, 
this  communication  of  ventricles,  will  suffer  but 
little  confusion  of  the  blood  which  flows  into  the 
ventricles,  because  each  ventricle  receiving  and 
discharging  the  same  quantity  of  blood,  at  the  same 
time,  they  will  balance  each  other,  and  thereby  such 
a mixture  will  be  very  much  prevented.  Mr. 
Monro  observes,  that  the  water  tortoise  has  very 
large  lungs,  consisting  of  larger  vesicles  than  land 
animals,  and  that  they  receive  a great  quantity  of 
air  to  furnish  that  je  ne  S9ai  quoi  so  necessary  for 
the  life  of  animals  ; the  same  thing  I have  observed 
in  frogs. 

As  to  the  reason  of  women’s  bringing  forth  at 
the  usual  time  ; it  has  been  said,  that  at  that  time 
the  head  of  the  child  begins  to  be  specifically  heav- 
ier than  the  rest  of  the  body,  and  therefore  must 
fall  lowest  in  the  fluid  it  lies  in,  which  being  an 
uneasy  posture,  makes  the  child  struggle,  and 


o o 


290 


OF  THE  EYE* 


bring  on  the  labour.  But  it  is  not  true,  that  the 
head  then  alters  its  specific  gravity  ; or,  if  it  did, 
there  is  seldom  fluid  enough  in  the  amnion  for  this 
purpose  ; and  besides,  this  could  only  happen  right 
in  one  posture,  and  would  usually  happen  wrong 
in  brutes. 


CHAPTER  IV. 


OF  THE  EYE. 


1 HE  figure,  situation,  and  use  of  the  eyes, 
together  with  the  eyebrows,  eyelashes,  and  eye- 
lids, being  well  known,  I need  only  describe 
what  is  usually  shewn  by  dissecting.  The  orbit 
of  the  eye,  or  cavity  in  which  it  is  contained, 
is  in  all  the  vacant  places  filled  with  a loose  fat, 
which  is  a proper  medium  for  the  eye  to  rest  in, 
and  serves  as  a socket  for  it  to  be  moved  in.  In 
the  upper  and  outer  part  of  the  orbit,  is  seated  the 
lacrymal  gland.  Its  use  is  to  furnish  at  all  times 
water  enough  to  wash  off  dust,  and  to  keep  the 
outer  surface  of  the  eye  moist,  without  which 
the  tunica  cornea  would  be  less  pellucid,  and  the 
rays  of  light  would  be  disturbed  in  their  passage  ; 
and  that  this  liquor  may  be  rightly  disposed  of,  we 
frequently  close  the  eyelids  to  spread  it  equally, 
even  when  we  are  not  conscious  of  doing  it.  At 
the  inner  corner  of  the  eye,  between  the  eyelids. 


OF  THE  EYE. 


291 


stands  a caruncle,  which  seems  to  be  placed  to 
keep  that  corner  of  the  eyelids  from  being  totally 
closed,  that  any  tears  or  gummy  matter  may  flow 
from  under  the  eyelids,  when  we  sleep,  or  into 
the  puncta  lacrymalia,  which  are  little  holes,  one 
in  each  eyelid,  near  this  corner,  to  carry  off  into 
the  ductus  ad  nasum  any  superfluous  tears. 

The  first  membrane  of  the  eye  is  called  con- 
junctiva ; it  covers  so  much  of  the  eye  as  is  called 
the  white,  and  being  reflected  all  round,  it  lines 
the  two  eyelids ; it  being  thus  returned  from  the 
eye  to  the  inside  of  the  eyelids,  it  effectually  hin- 
ders any  extraneous  bodies  from  getting  behind  the 
eye  into  the  orbit,  and  smooths  the  parts  it  cov- 
ers, which  makes  the  friction  less  between  the  eye 
and  the  eyelids.  This  coat  is  very  full  of  blood 
vessels,  as  appears  upon  any  inflammation. 

Tunica  sclerotis,  and  cornea,  make  together 
one  firm  case  of  a proper  form,  for  the  use 
of  the  other  coats  and  humours.  The  fore  part 
of  this  strong  coat  being  transparent,  and  like 
horn,  is  called  cornea,  and  the  rest  sclerotis.  Un- 
der the  cornea  lies  the  iris,  which  is  an  opaque 
membrane,  like  the  tunica  choroides,  but  of  dif- 
ferent colours  in  different  eyes,  such  as  the  eye 
appears,  as  grey,  black,  or  hazel ; for  being  seat- 
ed under  the  tunica  cornea,  it  gives  such  an  ap- 
pearance to  that  as  it  has  itself.  The  middle  of 
it  is  perforated  for  the  admission  of  the  rays  of 
light,  and  is  called  the  pupil.  Immediately  under 


292 


OF  THE  EYE. 


the  iris  lie  the  processus  ciliares,  like  radial  lines 
from  a lesser  circle  to  a greater.  When  these  pro- 
cesses contract,  they  dilate  the  pupil  to  suffer  more 
rays  of  light  to  enter  into  the  eye  ; and  the  con- 
trary is  done  by  the  circular  fibres  of  the  iris, 
which  act  as  a sphincter  muscle  : but  these  changes 
are  not  made  with  great  quickness,  as  appears  from 
the  eyes  being  oppressed  with  a strong  light  for 
some  time,  after  we  come  out  of  a dark  place, 
and  from  the  contrary  effect  in  going  suddenly 
from  a light  place  to  a dark  one.  And  as  the  pu- 
pil always  dilates  in  darker  places,  to  receive  more 
rays  of  light,  so  when  any  disease  makes  some  of 
those  rays  ineffectual,  which  pass  through  the 
pupil,  it  dilates  as  in  dark  places  to  admit  more 
light  ; therefore  a dilated  pupil  is  a certain  sign  of 
a bad  eye,  and  this  may  be  discerned  usually  sooner 
than  the  patient  discerns  any  defect  in  vision.  In 
men  the  pupil  is  round,  which  fits  them  to  see 
every  way  alike  : it  is  also  round  in  animals  that 
are  the  prey  both  of  birds  and  beasts.  But  gra- 
minivorous brutes,  that  are  too  large  to  be  the  prey 
of  birds,  have  it  oblong  horizontally,  which  fits 
them  to  view  a large  space  upon  the  earth  ; while 
animals  of  the  cat  kind,  who  climb  trees  and  prey 
indifferently  on  birds  or  animals  that  hide  in  the 
earth,  have  their  pupils  oblong  the  contrary  way, 
which  fits  them  best  to  look  upward  and  down- 
ward at  once.  Besides  these  there  are  other  anh 
mals  whose  pupils  are  in  these  forms,  but  in  less 


OF  THE  EYE. 


293 


proportions,  so  as  best  to  fit  their  ways  of  life. 
Immediately  under  the  sclerotis,  is  a membrane  of 
little  firmness,  called  choroides.  In  men  it  is  of 
a rusty  dark  colour,  such  as  will  bury  almost  all 
the  rays  of  light,  that  pass  through  the  tunica 
retina,  which  if  it  were  of  a brighter  colour, 
would  reflect  many  of  the  rays  upon  the  x*etina, 
and  make  a second  image  upon  the  first  somewhat 
less,  and  less  distinct,  but  both  together  stronger ; 
which  is  the  case  of  brutes  of  prey,  where  a great 
part  of  this  coat  is  perfectly  white,  which  makes 
them  see  bodies  of  all  colours  in  the  night  better 
than  men,  for  white  reflects  all  colours  : but 
brutes  that  feed  only  on  grass,  have  the  same  parts 
of  this  membrane  of  a bright  green,  which  enables 
them  also  to  see  with  less  light,  and  makes  grass 
an  object  that  they  can  discern  with  greatest 
strength.  But  these  advantages  in  brutes  necessa- 
rily destroy  great  accuracy  in  vision,  which  is  of 
little  or  no  use  to  them,  but  to  men  of  great  conse- 
quence. This  green  part  of  the  tunica  choroides 
in  animals  that  graze,  may  properly  be  called  mem- 
brana  uvea,  from  its  resemblance  in  colour  to  an 
unripe  grape.  But  in  men’s  eyes  only  a white 
circle  round  the  back  side  of  the  choroides  near  the 
cornea,  is  called  uvea. 

Immediately  under  the  tunica  choroides 
lies  the  tunica  retina,  which  is  the  optic  nerve 
expanded  and  coextended  with  the  choroides. 
Rays  of  light  striking  upon  this  membrane,  the 


294 


OF  THE  EYE. 


sensation  is  conveyed  by  the  optic  nerves,  to  the 
common  sensorium  the  brain.  These  nerves  do  not 
enter  at  the  middle  of  the  bottom  of  the  eyes, 
but  nearer  the  nose  ; for  those  rays  of  light  being 
ineffectual  for  vision  that  fall  upon  the  entrance  of 
the  optic  nerves,  it  is  fit  they  should  so  enter,  as 
that  the  same  object  or  part  of  any  object  should 
not  be  unperceived  in  both  eyes,  as  would  have 
been  the  case,  had  they  been  otherwise  inserted  ; 
which  appears  from  a common  experiment  of  part 
of  an  object  being  lost  to  one  eye,  when  we  are 
looking  towards  it  with  the  other  shut.  I know 
a gentleman,  who  having  lost  one  eye  by  the  small- 
pox, and  going  through  a hedge,  a thorn  unseen 
(probably  from  this  cause)  struck  the  other  and 
put  it  out.  The  two  optic  nerves,  soon  after  they 
arise  out  of  the  brain,  join,  and  seem  perfectly 
united  ; yet  from  the  following  case  I am  not 
without  suspicion  of  their  fibres  being  preserved 
distinct,  and  that  the  nerve  of  each  eye  arises 
wholly  from  the  opposite  side  of  the  brain,  or 
else  that  the  other  nerves  throughout  the  body  arise 
from  the  brain,  and  medulla  oblongata,  on  the 
sides  opposite  to  those  they  come  out  of.  A sol- 
dier, who  was  my  patient  in  the  hospital  about 
five  years  since,  had,  by  a push  with  a broad 
sword,  his  left  eye  raised  in  the  orbit,  which  I 
replaced  with  my  fingers  ; it  was  presently  follow- 
ed with  excessive  pain  in  the  right  side  of  the 
head  only  ; and  a loss  of  the  sense  of  feeling  and 


OF  THE  EYE. 


295 

motion  in  both  the  right  limbs  ; the  sense  of  feel- 
ing  he  recovered  by  degrees  in  about  a month,  and 
soon  after  began  to  recover  their  motion,  but  was 
twelve  months  before  he  could  walk,  and  lift  up 
his  hand  to  his  head  ; and  in  about  two  years  re- 
covered all  but  the  sight  of  the  wounded  eye, 
which  indeed  did  not  appear  perfect.  In  fish 
these  nerves  arise  distinct  from  the  opposite  sides 
of  the  brain,  and  cross  without  uniting ; but  as 
these  animals  have  their  eyes  so  placed,  as  not  to 
see  the  same  object  with  both  eyes  at  once,  where- 
as animals,  whose  optic  nerves  seem  to  unite,  do 
see  the  same  object  with  both  eyes  at  once,  one 
would  suspect  that  in  one  they  were  joined  to 
make  the  object  not  appear  double,  and  in  the 
other  distinct,  to  make  their  two  eyes  (as  they  are 
to  view  different  objects  at  the  same  time)  inde- 
pendent on  each  other  : and  yet  from  the  follow- 
ing cases,  the  seeing  objects  single  seems  not  to 
depend  upon  any  such  union,  nor  from  the  light 
striking  upon  corresponding  fibres  of  the  nerves, 
as  others  have  believed,  but  upon  a judgment  from 
experience,  all  objects  appearing  single  to  both 
eyes  in  the  manner  we  are  most  used  to  observe 
them,  but  in  other  cases  double  ; for  though  we 
have  a distinct  image  from  each  eye  sent  to  the 
brain,  yet  while  both  these  images  are  of  an  ob- 
ject seen  in  one  and  the  same  place,  we  conceive 
of  them  as  one  ; so  when  one  image  appears  to 
the  eyes  (when  they  are  distorted  or  wrong  di- 


296 


OF  THE  EYE. 


rected)  in  two  different  places,  it  gives  the  idea  of 
two  ; and  when  two  bodies  are  seen  in  one  plac6, 
as  two  candles  rightly  placed,  through  one  hole 
in  a board,  they  appear  one.  But  cases  of  this 
kind  being  too  numerous,  I will  conclude  with 
one  very  remarkable,  and,  I think,  much  in  favour 
of  this  opinion.  A gentleman,  who  from  a blow 
on  the  head  had  one  eye  distorted,  found  every 
object  appear  double,  but  by  degrees,  the  most  fa- 
miliar ones  became  single,  and  in  time,  all  objects 
became  so,  without  any  amendment  of  the  distor- 
tion. 

The  inside  of  the  eye  is  filled  with  three  hu- 
mours, called  aqueous,  crystalline,  and  vitreous. 
The  aqueous  lies  foremost,  and  seems  chiefly  of 
use  to  prevent  the  crystalline  from  being  easily 
bruised  by  rubbing,  or  a blow  ; and  perhaps  it 
serves  for  the  crystalline  humour  to  move  forward 
in,  while  we  view  near  objects,  and  backward  for 
remoter  objects  ; without  which  mechanism,  or, 
in  the  place  of  it,  a greater  convexity  in  the  crystal- 
line humour  in  the  former  case,  and  a less  con- 
vexity in  the  latter,  I do  not  imagine,  according 
to  the  laws  of  optics,  how  we  could  so  distinctly  see 
objects  at  different  distances.  However  it  is  in 
land  animals,  I think  we  may  plainly  see  that 
fish  move  their  crystalline  humour  nearer  the  bot- 
tom of  the  eye  when  they  are  out  of  water,  and 
the  contrary  way  in  water  ; because  light  is  less 
refracted  from  water  through  the  crystalline  hu- 


OF  THE  EYE. 


297 


momr  than  from  air.  Some  have  said,  that  am- 
phibious animals  have  a membrane  like  the  mem- 
brana  nictitans  of  birds,  which  serves  them  as  a 
lens  in  the  water.  I have  examined  the  eye  of  a 
crocodile,  which  Sir  Hans  Sloan  kept  in  spir- 
its, and  I found  this  membrane  equally  thick 
and  dense,  and  consequently  unfit  for  this  pur- 
pose, or,  I believe,  any  other,  except  that  obvious 
one,  of  defending  the  eye  from  the  water.  Next 
behind  the  aqueous  humour  lies  the  crystalline  ; its 
shape  is  a depressed  spheroid,  it  is  distinctly  con- 
tained in  a very  fine  membrane  called  aranea. 
The  use  of  this  humour  is  to  refract  the  rays  of 
light  which  pass  through  it,  so  that  each  pencil  of 
rays  from  the  same  point  of  any  object  may  be 
united  upon  the  retina,  as  in  a camera  obscura, 
to  make  the  stronger  impression  : and  though  by 
this  union  of  the  rays  a picture  inverted  is  made 
upon  the  retina,  yet  surely  it  is  the  impulse  only 
of  the  rays  upon  the  retina  that  is  the  cause  of 
vision  ; for  had  the  colour  of  the  retina  been  black, 
and  consequently  unfit  to  receive  such  a picture, 
would  not  the  impulse  of  light  upon  it  have  been 
sufficient  for  vision  ? or  would  such  a picture,  if 
it  could  have  been  made  without  any  impulse, 
have  ever  conveyed  any  sensation  to  the  brain  ? 
Then  if  the  impulse  of  light  upon  the  retina,  and 
not  the  image  upon  the  retina,  is  the  cause  of  vi- 
sion ; when  we  inquire  why  an  image  inverted  in 
the  eye  appears  otherwise  to  the  mind,  might 

pP 


29a 


OF  THE  EYE. 


we  not  expect  to  find  the  true  cause  from  consul^ 
ering  the  directions  in  which  the  rays  strike  the 
retina,  as  we  judge  of  above  and  below  from  a. 
like  experience,  when  any  thing  strikes  upon  any 
part  of  our  bodies  ? Nevertheless,  in  viewing  an 
object  through  a lens,  we  conceive  of  it  as  in- 
verted ; when  as  in  receiving  the  impulses  of  light 
in  the  same  manner,  and  having  the  picture  on 
the  retina  in  the  same  attitude,  when  we  stand 
on  our  heads  without  the  lens,  we  have  not 
the  same,  but  the  contrary  idea  of  the  position  of 
the  object.  Though  I have  considered  this  hu- 
mour only  as  a refractor  of  light,  yet  the  first  and 
greatest  refraction  is  undoubtedly  made  in  the  cor- 
nea ; but  it  being  concavo-convex,  like  glasses  of 
that  kind,  while  one  side  makes  the  rays  of  light 
converge,  the  other  diverges  them  again.  The 
same  thing  also  may  be  observed  of  the  aqueous 
humour,  which  is  indeed  more  concave  than  con- 
vex ; but  when  the  crystalline  humour  is  removed 
in  the  couching  a cataract,  the  aqueous  possesses  its 
place  and  becomes  a lens  ; but  that  refracting  light 
less  than  the  crystalline,  whose  place  and  shape  it 
partly  takes,  the  patient  needs  a convex  glass  to 
see  accurately.  In  some  eyes,  either  this  humour 
heine;;  too  convex  or  too  distant  from  the  retina, 
the  rays  unite  too  soon,  unless  the  object  is  held 
very  near  to  the  eye,  which  fault  is  remediable 
by  a concave  glass  ; as  the  contrary  fault,  common 
to  old  persons,  is  by  a convex  glass.  If  the  eye. 


OF  THE  EYE. 


299 


liad  been  formed  for  a nearer  view,  the  object 
would  often  obstruct  the  light ; if  it  had  been 
much  farther,  light  enough  would  not  commonly 
have  been  produced  from  the  object  to  the  eye. 
In  fish  the  crystalline  humour  seems  a perfect 
sphere,  which  is  necessary  for  them,  because  light 
being  less  refracted  from  water  through  the  crys- 
talline humour  than  from  air,  that  defect  is  com- 
pensated by  a more  convex  lens.  The  vitreous 
humour  lies  behind  the  crystalline,  and  fills  up  the 
greatest  part  of  the  eye  : its  fore  side  is  concave 
for  the  crystalline  humour  to  lodge  in,  and  its 
back  side  being  convex,  the  tunica  retina  is  spread 
over  it  ; it  serves  as  a medium  to  keep  the  crystal- 
line humour  and  the  retina  at  a due  distance. 

The  larger  animals  having  larger  eyes,  their 
organs  of  vision,  like  a microscope  with  a large 
lens,  are  fit  to  take  in  a greater  view,  but  in  that 
view  things  are  not  so  much  magnified  ; in  lesser 
animals  a small  space  is  discerned,  such  as  is  their 
sphere  of  action,  but  that  greatly  magnified,  not 
really  so  in  either  case,  but  comparatively,  for 
vision  shews  not  the  real  magnitude  of  objects, 
but  their  proportions  one  to  another.  Fish  have 
their  eyes,  and  particularly  their  pupils,  larger 
than  land  animals,  because  there  is  less  light,  and 
that  not  so  far  distributed  in  water  as  in  the  air. 
In  all  inflammations  in  the  eye,  the  utmost  haste 
should  be  made,  by  bleeding,  purging,  abstinence, 
&c.  to  get  rid  of  the  inflammation,  because  a con- 


500  OF  THE  EYE. 

tinued  inflammation  seldom  fails  to  make  white 
opaque  scars  in  the  cornea,  which  cause  dimness 
if  not  blindness ; and  no  eye  water  with  powders 
in  it  should  ever  be  put  upon  the  eye,  because  none 
can  be  made  fine  enough. 

An  account  of  observations  made  by  a young  gentle- 
man who  was  born  blind , or  lost  his  sight  so  early 
that  he  had  no  remembrance  of  ever  having  seen , 
and  was  couched  between  thirteen  and  fourteen  years 
of  age. 

THOUGH  we  say  of  this  gentleman  that  he 
was  blind,  as  we  do  of  all  people  who  have  ripe 
cataracts,  yet  they  are  never  so  blind  from  that 
cause  but  that  they  can  discern  day  from  night, 
and  for  the  most  part,  in  a strong  light,  distinguish 
black,  white,  and  scarlet  ; but  they  cannot  per- 
ceive the  shape  of  any  thing  ; for  the  light,  by 
which  these  perceptions  are  made,  being  let  in  ob- 
liquely through  the  aqueous  humour,  or  the  ante- 
rior surface  of  the  crystalline,  by  which  the  rays 
cannot  be  brought  into  a focus  upon  the  retina, 
they  can  discern  in  no  other  manner,  than  a sound 
eye  can  through  a glass  of  broken  jelly,  where  a 
great  variety  of  surfaces  so  differently  refract  the 
light,  that  the  several  distinct  pencils  of  rays  can- 
not be  collected  by  the  eye  into  their  proper  foci  ; 
wherefore  the  shape  of  an  object  in  such  a case 
cannot  be  at  all  discerned,  though  the  colour  may  j 


OF  THE  EYE. 


301 


And  thus  it  was  with  this  young  gentleman,  who, 
though  he  knew  these  colours  asunder  in  a good 
light,  yet  when  he  saw  them  after  he  was 
couched,  the  faint  ideas  he  had  of  them  before, 
were  not  sufficient  for  him  to  know  them  by  after- 
wards, and  therefore  he  did  not  think  them  the 
same  which  he  had  before  known  by  those  names. 
Now  scarlet  he  thought  the  most  beautiful  of  all 
colours,  and  of  others  the  most  gay  were  the  most 
pleasing  ; whereas  the  first  time  he  saw  black  it 
gave  him  great  uneasiness,  yet  after  a little  time  he 
was  reconciled  to  it ; but  some  months  after,  see- 
ing by  accident  a negro  woman,  he  was  struck 
with  great  horror  at  the  sight. 

When  he  first  saw,  he  was  so  far  from  mak- 
ing any  judgment  about  distances,  that  he  thought 
all  objects  whatever  touched  his  eyes  (as  he  ex- 
pressed it)  as  what  he  felt  did  his  skin,  and  thought 
no  object  so  agreeable  as  those  which  were  smooth 
and  regular,  though  he  could  form  no  judgment 
of  their  shape,  or  guess  what  it  was  in  any  object 
that  was  pleasing  to  him  : he  knew  not  the  shape 
of  any  thing,  nor  any  one  thing  from  another, 
however  different  in  shape  or  magnitude : but 
upon  being  told  what  things  were,  whose  form 
he  before  knew  from  feeling,  he  would  carefully 
observe,  that  he  might  know  them  again  ; but 
having  too  many  objects  to  learn  at  once,  he  for- 
got many  of  them  ; and  (as  he  said)  at  first  he 
learned  to  know,  and  again  forgot  a thousand 


502 


or  THE  EYE. 


•things  in  a day.  One  particular  only,  though  it 
may  appear  trifling,  I will  relate  : Having  often 
forgot  which  was  the  cat,  and  which  the  dog,  he 
was  ashamed  to  ask  5 but  catching  the  cat,  which 
he  knew  by  feeling,  he  was  observed  to  look  at 
her  steadfastly,  and  then,  setting  her  down,  said, 
So,  puss,  I shall  know  you  another  time.  He  was 
very  much  surprised,  that  those  things  which  he 
had  liked  best,  did  not  appear  most  agreeable  to 
his  eyes,  expecting  those  persons  would  appear 
most  beautiful  that  he  loved  most,  and  such  things 
to  be  most  agreeable  to  his  sight  that  were  so  to 
his  taste.  We  thought  he  soon  knew  what  pic- 
tures represented,  which  were  shewed  to  him, 
but  we  found  afterwards  we  were  mistaken  ; for 
about  two  months  after  he  was  couched,  he  dis- 
covered at  once  they  represented  solid  bodies, 
when  to  that  time  he  considered  them  only  as 
party  coloured  planes,  or  surfaces  diversified  with 
variety  of  paint  ; but  even  then  he  was  no  less 
surprised,  expecting  the  pictures  would  feel  like 
the  things  they  represented,  and  was  amazed 
when  he  found  those  parts,  which  by  their  light 
and  shadow  appeared  now  round  and  uneven,  felt 
only  flat  like  the  rest,  and  asked  which  was  the  ly- 
ing sense,  feeling,  or  seeing  ? 

Being  shewn  his  father’s  picture  in  a locket 
at  his  mother’s  watch,  and  told  what  it  was,  he 
acknowledged  a likeness,  but  was  vastly  surprised  ; 
asking  how  it  could  be,  that  a large  face  could 


SF  THE  E7E. 


303 


be  expressed  in  so  little  room  ; saying,  it  should 
have  seemed  as  impossible  to  him,  as  to  put  a 
bushel  of  any  thing  into  a pint. 

At  first,  he  could  bear  but  very  little  light,  and 
the  things  he  saw  he  thought  extremely  large  5 
but  upon  seeing  things  larger,  those  first  seen  he 
conceived  less,  never  being  able  to  imagine  any 
lines  beyond  the  bounds  he  saw  ; the  room  he 
was  in,  he  said,  he  knew  to  be  but  part  of  the 
house,  yet  he  could  not  conceive  that  the  whole 
house  could  look  bigger.  Before  he  was  couched, 
he  expected  little  advantage  from  seeing,  worth 
undergoing  an  operation  for,  except  reading  and 
writing ; for  he  said,  he  thought  he  could  have 
no  more  pleasure  in  walking  abroad  than  he  had 
in  the  garden,  which  he  could  do  safely  and  read- 
ily. And  even  blindness,  he  observed,  had  this 
advantage,  that  he  could  go  any  where  in  the  dark, 
much  better  than  those  who  can  see  ; and  after 
he  had  seen,  he  did  not  soon  lose  this  quality,  nor 
desire  a light  to  go  about  the  house  in  the  night. 
He  said,  every  new  object  was  a new  delight ; and 
the  pleasure  was  so  great,  that  he  wanted  words  to 
express  it ; but  his  gratitude  to  his  operator  he 
could  not  conceal,  never  seeing  him  for  some  time 
without  tears  of  joy  in  his  eyes,  and  other  marks  of 
affection  : and  if  he  did  not  happen  to  come 
at  any  time  when  he  was  expected,  he  would  be 
so  grieved,  that  he  could  not  forbear  crying  at  his 
disappointment.  A year  after  first  seeing,  being 


304 


OF  THE  EAR. 


carried  upon  Epsom  Downs,  and  observing  a large 
prospect,  he  was  exceedingly  delighted  with  it, 
and  called  it  a new  ldnd  of  seeing-.  And  now 

o 

* being  lately  couched  of  his  other  eye,  he  says, 
that  objects  at  first  appeared  large  to  this  eye,  but 
not  so  large  as  they  did  at  first  to  the  other  ; and 
looking  upon  the  same  object  with  both  eyes,  he 
thought  it  looked  about  twice  as  large  as  with 
the  first  couched  eye  only,  but  not  double,  that 
we  can  any  ways  discover. 

I have  couched  several  others  who  were  born 
blind,  whose  observations  were  of  the  same  kind  ; 
but  they  being  younger,  none  of  them  gave  so 
full  an  account  as  this  gentleman. 


CHAPTER  V. 

OF  THE  EAR. 

The  figure  and  situation  of  the  outer  ear  needs 
no  description.  Its  inner  substance  is  cartilage, 
which  preserves  its  form  without  being  liable 
to  break.  Its  use  is  to  collect  sounds,  and  direct 
them  into  the  meatus  auditorius,  which  is  the 
passage  that  leads  to  the  drum  ; this  passage  is  lin- 
ed with  a glandular  membrane,  in  which  also  is 
some  hair  ; the  cerumen  which  is  separated  by  these 
glands,  being  spread  all  over  this  membrane,  and 
its  hairs,  serve  to  defend  the  membrane  from  the 


OF  THE  EAR. 


305 


outer  air,  and  to  entangle  any  insect  that  might 
otherwise  get  into  the  ear.  Sometimes  this  wax 
being  separated  in  too  great  quantity,  it  fills  up 
the  passage  and  causes  deafness ; and  those  great 
discharges  of  matter  from  the  meatus  auditorius, 
which  are  commonly  called  imposthumes  in  the 
ear,  I think,  can  be  nothing  else  but  ulcerations,  or 
great  secretions  from  these  glands.  At  the  farther 
end  of  the  meatus  auditorius  lies  the  membrana  tym- 
pani,  which  is  extended  upon  a bony  ridge  almost 
circular.  Its  situation  in  men  and  brutes  is  nearly 
horizontal,  inclined  towards  the  meatus  auditorius, 
which  is  the  best  position  to  receive  sounds  ; a 
great  part  of  them  being  ordinarily  reverberated 
from  the  earth.  In  men  and  brutes  it  is  concave 
outward,  but  in  birds  it  is  convex  outward,  so  as  to 
make  the  upper  side  of  it  nearly  perpendicular  to 
the  horizon,  which  seems  fitter  to  hear  each  other’s 
sounds  when  they  are  high  in  the  air,  where  they 
can  receive  but  little  reverberated  sound.  This 
membrane  does  not  entirely  close  the  passage,  but 
has  on  one  side  a small  aperture  covered  with  a 
valve.  I found  it  once  half  open  in  a man  that  I 
dissected,  who  had  not  been  deaf ; and  I have  seen 
a man  smoke  a whole  pipe  of  tobacco  out  through 
his  ears,  which  must  go  from  the  mouth  through 
the  eu§tachian  tube,  and  through  the  tympanum  ; 
yet  this  man  heard  perfectly  well.  These  cases  oc- 
casioned me  to  break  the  tympanum  in  both  ears 
of  a dog,  and  it  did  not  destroy  his  hearing,  but  for 
Q q 


306 


OF  THE  EAR. 


some  time  he  received  strong  sounds  with  great 
horror.  Mr.  St.  Andre  has  assured  me,  that  a 
patient  of  his  had  the  tympanum  destroyed  by  an 
ulcer,  and  the  auditory  bones  cast  out,  without  de- 
stroying his  hearing.  From  these  and  other  like 
cases  it  may  be  concluded,  that  the  membrana  tym- 
pani,  though  useful  in  hearing,  is  not  the  seat  of 
that  sense  ; and  if  any  disease  in  that  membrane 
should  obstruct  the  passage  of  sounds  to  the  inter- 
nal parts  of  the  ear,  which  are  the  seat  of  that 
sense,  an  artificial  passage  through  that  membrane 
might  recover  hearing,  as  the  removing  the  crystal- 
line humour,  when  that  obstructs  the  light,  recov- 
ers sight.  Some  years  since  a malefactor  was  par- 
doned on  condition  that  he  suffered  this  experiment, 
but  he  falling  ill  of  a fever,  the  operation  was  de- 
ferred, during  which  time  there  was  so  great  a 
public  clamour  raised  against  it  that  it  was  afterwards 
thought  fit  to  be  forbid.  In  very  young  children 
I have  always  found  this  membrane  covered  with 
mucus,  which  seems  necessary  to  prevent  sounds 
from  affecting  them  too  much,  there  being  no  pro- 
vision to  shut  the  ears,  as  there  is  for  the  eyes.  A 
gentleman  well  known  in  this  city,  having  had 
four  children  born  deaf,  was  advised  to  lay  blisters 
upon  the  heads  of  the  next  children  he  might  have, 
which  he  did  to  three  which  were  born  afterward, 
and  every  oiie’'of  them  heard  well.  It  seems  not 
unreasonable  to  suppose  that  too  great  a quantity  of 
this  mucus  upon  the  drum  might  be  the  cause  of 


@T  THE  EAR. 


307 


deafness  in  the  four  children,  and  that  the  discharge 
made  by  the  blisters  in  the  latter  cases  was  the  cause 
of  their  escaping  the  same  misfortune. 

Into  the  middle  of  the  tympanum  is  extended 
a small  bone  called  malleus,  whose  other  end  is 
articulated  to  a bone  called  incus,  which  is  also  ar- 
ticulated by  the  intervention  of  an  exceeding  small 
one,  called  orbiculare,  to  a fourth  bone  called  sta- 
pes. These  bones  are  contained  in  that  cavity  be- 
hind the  tympanum,  which  is  called  the  barrel  of 
the  ear  but  some  anatomists  call  the  barrel  only 
tympanum,  and  the  membrane  membrana  tympani. 
The  malleus  being  moved  inward  by  the  mus- 
culus  obliquus  interims,  or  trochlearis,  it  extends 
the  tympanum  that  it  may  be  the  more  affected  by 
impulse  of  sounds  when  they  are  too  weak.  This 
muscle  rises  from  the  cartilaginous  part  of  the  eu- 
stachian  tube,  and  passing  from  thence  in  a proper 
groove,  it  is  reflected  under  a small  process,  and 
thence  passes  on  perpendicular  to  the  tympanum, 
to  be  inserted  into  the  handle  of  the  malleus, 
sometimes  with  a double  tendon.  Parallel  to  this 
muscle  lies  another  extensor  of  the  tympanum, 
called  obliquus  externus  ; it  arises  from  the  outer 
and  upper  part  of  the  eustachian  tube,  and  passing 
through  the  same  hole  with  the  chorda  tympani* 
which  is  a branch  of  the  fifth  pair  of  nerves,  it  is 
inserted  into  a long-  orocess  of  the  malleus : this 
is  not  so  obviously  an  extensor  as  to  be  known 
'to  be  so  without  an  experiment.  The  muscle 


SOS  or  the  ear. 

which  relaxes  this  membrane  is  called  externus 
tympani ; it  arises  from  the  upper  part  of  the  au- 
ditory passage,  under  the  membrane  which  lines 
that  passage,  and  is  inserted  into  the  upper  process 
of  the  malleus.  The  relaxation  of  the  tympanum 
is  made  by  this  muscle,  without  our  knowledge, 
when  sounds  are  too  strong ; and  as  the  pupil  of 
the  eye  is  contracted  when  we  have  too  much 
light,  and  dilated  when  there  is  too  little,  from 
what  cause  soever,  so  when  sounds  are  too  low, 
or  the  sense  of  hearing  imperfect,  from  whatever 
cause,  the  extensors  of  the  tympanum  stretch  it  to 
make  the  impulse  of  sounds  more  effectual  upon 
it,  just  as  in  the  case  of  the  common  drum,  and 
the  chords  of  any  musical  instrument.  From  the 
cavity  behind  the  tympanum,  which  is  called  the 
barrel  of  the  ear,  goes  the  eustachian  tube,  or 
iter  ad  palatum  ; it  ends  cartilaginous  behind  the 
palate.  This  passage  seems  to  be  exactly  of  the 
same  use  with  the  hole  in  the  side  of  the  common 
drum,  that  is,  to  let  the  air  pass  in  and  out  from 
the  barrel  of  the  ear  to  make  the  membrane  vibrate 
the  better,  and  perhaps  in  the  ear,  which  is  closer 
than  a common  drum,  to  let  air  in  or  out  as  it 
alters  in  density ; and  if  any  fluid  should  be  sepa- 
rated in  the  barrel  of  the  ear,  to  give  it  a passage 
out.  This  passage  being  obstructed,  as  it  is  some- 
times, by  a large  polypus  behind  the  uvula,  it 
causes  great  difficulty  of  hearing,  and  sometimes, 
when  the  meatus  auditorius  is  obstructed,  a man 


6F  THE  EAR. 


309 


opening  his  mouth  wide,  will  hear  pretty  well 
through  this  passage,  which  is  often  so  open,  as 
that  syringing  water  through  the  nose,  it  shall  pass 
through  into  the  barrel  of  the  ear,  and  cause  deaf- 
ness for  some  time.  If  any  one  would  try  how 
he  can  hear  this  way,  let  him  stop  his  ears,  and 
take  between  his  teeth  the  end  of  a wire,  or  chord 
that  will  vibrate  well,  and  holding  the  other  end, 
strike  it,  and  the  sound  that  he  hears  will  be 
through  this  passage.  To  the  stapes  there  is  one 
muscle,  called  musculus  stapedis  ; it  lies  in  a long 
channel,  and  ending  in  the  stapes,  it  serves  so  pull 
the  stapes  off  of  the  fenestra  ovalis,  which  other- 
wise it  covers.  Besides  the  fenestra  ovalis,  there 
is  another  near  it,  somewhat  less,  called  rotunda  ; 
these  two  holes  lead  to  a cavity  called  vestibulum, 
which  leads  into  other  cavities  aptly  called  cochlea, 
and  three  semicircular  canals,  or  all  together  the 
labyrinth,  in  which  are  spread  the  auditory  nerves, 
to  receive  and  convey  the  impulse  of  sounds  to 
the  common  sensorium  the  brain  ; and  surely  the 
chorda  tympani,  which  is  a branch  of  the  fifth 
pair  of  nerves,  may  also  convey  these  sensations 
to  the  brain.  The  two  holes,  called  fenestra  ovalis 
and  rotunda,  are  closed  with  a fine  membrane,  like 
the  membrane  called  the  drum,  and  the  larger 
being  occasionally  covered  and  uncovered  by  the 
stapes,  sounds  are  thereby  made  to  influence  more 
or  less,  as  best  serves  for  hearing ; and  this  advan- 
tage being  added  to  that  of  a lax  or  tense  tympa- 


310  SENSES  OF  SMELLING, 

imm,  the  effect  of  sounds  may  be  greatly  increased 
or  lessened  upon  the  auditory  nerves,  expanded  in 
the  labyrinth.  In  the  strongest  sounds,  the  tympa- 
num may  be  lax,  and  the  fenestra  ovalis  covered  ; 
and  for  the  lowest,  the  tympanum  tense,  and  the 
fenestra  uncovered.  If  sounds  propagated  in  the 
ear  were  heard  less,  we  might  often  be  in  danger 
before  we  were  apprised  of  it j and  if  the  organs  of 
hearing  were  much  more  perfect,  unless  our  un- 
derstandings were  so  too,  we  should  commonly  hear 
more  things  at  once  than  we  could  attend  to. 

CHAPTER  VI, 

OF  THE  SENSES  OF  SMELLING,  TASTING,  ANB 
FEELING. 

The  sense  of  smelling  is  made  by  the  effluvia, 
which  are  conveyed  by  the  air  to  the  nerves, 
ending  in  the  membranes  which  line  the  nose  and 
its  lamella.  In  men  these  lamella  are  few,  and 
the  passage  through  the  nose  not  difficult  ; hence 
fewer  effluvia  v/ill  strike  the  nerves,  than  in  ani- 
mals of  more  exquisite  smell,  whose  noses  being 
full  of  lamella,  and  the  passage  for  the  air  narrow 
and  crooked,  few  of  the  effluvia  escape  one  place 
or  another  ; besides,  their  olfactory  nerves  may  be 
more  sensible.  Fish,  though  they  have  no  noses, 
yet  in  their  mouths  they  may  taste  effluvia  in  the 
water,  as  surely  those  fish  do,  who  seek  their  prey 


TASTING,  AND  FEELING. 


311 


in  the  darkest  nights,  and  in  great  depths  of  water, 
there  being  more  nerves  disposed  in  their  mouths 
than  through  their  whole  bodies  beside,  the  optic 
excepted ; and  it  seems  as  if  it  was  done  for  this 
purpose ; for  the  mere  sense  of  tasting  is  ordinari- 
ly less  curious  in  them  than  in  land  animals  ; 
in  baiting  eel-baskets,  if  the  bait  has  lain  long  in 
water,  it  is  seldom  followed  ; but  upon  scarifying 
it  afresh,  which  will  make  it  emit  new  effluvia, 
it  serves  as  a fresh  bait.  The  sense  of  tasting  is 
made  in  the  like  manner  upon  the  nerves  which 
line  the  mouth,  as  is  that  of  feeling  upon  the  nerves 
distributed  throughout  the  body  ; of  which  I should 
speak  more  in  this  place,  if  I had  not  done  it  al- 
ready in  the  chapter  of  the  nerves. 


312 


TABLES'. 


TABLE  XX XL 

1 The  under  side  of  the  bladder. 

2 The  ureters. 

3 Vasa  deferentia. 

4 Vesiculae  seminales. 

5 The  prostrate  gland. 

6 Meatus  urinarius. 

7 A transverse  section  of  the  corpora  cavernosa 

penis. 

3 Corpus  cavernosum  urethrae. 

9  Urethra. 

10  Septum  penis. 

11  The  septum  between  the  corpus  cavernosum 

urethrae,  and  that  of  the  penis. 

12  The  corpora  cavernosa  penis  divided  by  the 

septum. 

13  Corpus  cavernosum  glandis. 


P.312. 


nr  MV  XXXI . 


» AB.  XXXII. 


TABLES. 


313 


TABLE  XXXII. 

1 That  side  of  the  uterus  which  is  next  the  gut. 

2 The  fallopian  tubes. 

3 The  fimbriae. 

4 Ovaria. 

5 The  mouth  of  the  uterus. 

6 Ligamenta  rotunda. 

7 The  inside  of  the  vagina. 

8 The  orifice  of  the  meatus  urinarius. 

9 The  glans  clitoridis. 

10  The  external  labia  of  the  vagina. 

11  The  nymphae,  which  are  continued  from  the 

praeputium  clitoridis. 


a r 


314 


TABLES. 


TABLE  XXXIII. 

The  parts  of  an  hermaphrodite  negro,  which  was 
neither  sex  perfect,  but  a wonderful  mixture  of 
both.  This  person  was  twenty  six  years  of  age, 
and  in  shape  perfectly  male. 

1 A clitoris,  when  erected,  almost  as  large  as  a 

penis. 

2 The  glands  of  the  clitoris. 

3 Labia,  or  a divided  scrotum  ; in  which  were 

perfect  testicles  with  ail  the  vessels. 

4 Nymphae. 

5 The  entrance  into  the  vagina,  where  were  carun- 

culae  myrtiformes. 

6 Furca  virginis. 

The  lower  ligure  represents  another  her- 
maphrodite, whose  shape  was  rather  female 
than  male,  but  too  young  to  have  female 
breasts,  or  a beard,  like  a male,  Xpon  the 
face.  . . 

7 The  glans  clitoridis. 

8 Nymphae. 

9 Labia  with  testicles  in  them,  divaricated  to 

shew  the  parts  between,  but  in  their  natural 
situation  very  like  the  other,  as  the  other 
when  divaricated  resembled  this. 

10  The  entrance  into  the  vagina. 

11  Furca  virginis. 

O 


ta  r.  X'X  \ m 


TAB . XX  XIV. 


F.315. 


TABLES. 


315 


TABLE  XXXIV. 

1 The  right  ventricle  of  a foetus  distended  with 

wax. 

2 The  risrht  auricle. 

O 

3 The  left  auricle. 

4 Branches  of  the  pulmonary  veins  of  the  right 

lobe  of  the  lungs,  those  of  the  left  being  cut 
off  short. 

5 The  arteries  of  the  left  lobe  of  the  lungs. 

6 The  vena  cava  descendens. 

7 Aorta  ascendens. 

8 Arteria  pulmonalis. 

9 Ductus  arteriosus. 

10  The  under  side  of  a heart  of  a younger  foetus. 

1 1 The  right  auricle  cut  open. 

12  The  cava  descendens  cut  open. 

13  Tub'erculum  Loweri. 

14  The  foramen  ovale  closed  with  its  valve. 

15  The  mouth  of  the  coronary  veins. 

16  The  umbilical  vein. 

17  Branches  of  the  vena  porta  in  the  liver. 

18  Ductus  venosus. 

19  Branches  of  the  cava  in  the  liver. 

20  Vena  cava. 


316 


TABLES. 


TABLE  XXXV. 

1 A cross  for  an  object. 

2 The  object  represented  on  the  retina  at  the  bot- 

tom of  each  eye. 

3 The  entrance  of  the  optic  nerves,  in  which  place 

no  object  is  represented. 

4 Cones,  within  which  all  objects  placed  are  dark 

to  each  eye,  the  rays  from  thence  falling  upon 
the  entrance  of  the  optic  nerves  ; but  that 
which  falls  upon  the  entrance  of  the  optic 
nerve  in  one  eye,  can  never  fall  upon  the  op- 
tic nerve  in  the  other. 

5  Pencils  of  rays  from  points  of  the  object  passing 
through  the  crystalline  humour,  where  they 
converge,  to  meet  in  a point  on  the  retina  to 
form  vision. 


TAB  XX  XV. 


/ ’ j r ti. 


TAB  XXXVI. 


P.  jjy. 


\ 


TABLES. 


317 


TABLE  XXXVI. 

1 A knife  passed  through  the  tunica  sclerotis,  un- 

der the  cornea  before  the  iris,  in  order  to  cut 
an  artificial  pupil  where  the  natural  one  is 
closed.  This  operation  I have  performed 
several  times,  with  good  success ; indeed  it 
cannot  fail  when  the  operation  is  well  done, 
and  the  eye  no  otherwise  diseased,  which  is 
more  than  can  be  said  for  couching  a cataract. 
In  this  operation  great  care  must  be  taken  to 
hold  open  the  eyelids  without  pressing  upon 
the  eye,  for  if  the  aqueous  humour  is  squeez- 
ed out  before  the  incision  is  made  in  the  iris, 
the  eye  grows  flaccid,  and  renders  the  opera- 
tion difficult. 

2 A crooked  needle  passed  through  a proptosis 

of  the  cornea  ; the  black  line  in  the  cornea 
encloses  the  piece  to  be  cut  out  with  a knife. 
The  operation  being  thus  done,  the  crystal- 
line humour  immediately  falls  out ; and  in  a 
few  days  the  lips  of  the  wound  unite.  This 
operation  is  very  useful,  and  attended  with 
but  little  pain.  I have  done  the  same  thing 
when  the  whole  eye  has  been  so  enlarged 
that  the  eyelids  could  not  be  closed,  which 
has  sunk  the  eye  in  the  head  ; but  this  ope- 
ration was  attended  with  such  violent  pain 
that  I cannot  much  recommend  it. 

) 

1 

) 

/ » 


313 


TABLES. 


3 Shews  how  an  opaque  scar  upon  the  cornea,  by- 

obstructing  part  of  each  pencil  of  rays,  makes 
a dimness  of  sight  without  a total  loss. 

4 Shews  how  a cataract  or  obstruction  of  the 

crystalline  humour  will  obstruct  the  light 
which  is  before  it.  And  how  some  side- 
light may  pass  to  the  retina  through  the 
aqueous  humour,  but  not  being  brought  into 
a focus  gives  only  a sense  of  light  without 
vision. 


t 

A 

‘ V 


TABLES. 


319 


TABLE  XXXVII. 


1 A bone  taken  out  from  the  first  process  of  the 

dura  mater  not  far  from  the  crista  galli. 

2 A bone  taken  out  of  the  muscular  part  of  the 

heart  of  a man. 

3 The  under  side  of  a bone  taken  out  of  a frac- 

tured scull. 

4 The  upper  side  of  a bone  from  the  same  scull. 

where  the  operation  of  the  trepan  had  been 
thrice  made.  This  girl  was  brought  into  the 
hospital  a week  after  the  accident.  I im- 
mediately opened  the  scalp,  and  let  out  about 
two  ounces  of  grumous  blood,  and  laid  the 
scull  bare  about  four  inches  one  way,  and 
three  the  other,  and  tied  the  blood  vessels, 
that  I might  make  the  operation  without 
much  difficulty  soon  after.  The  fracture 
extended  across  the  os  bregmatis  from  the 
sagittal  suture  to  the  temporal  bone  ; that 
part  next  the  os  frontis  was  depressed  equal 
to  its  thickness,  and  a great  deal  of  extrava- 
sated  blood,  and  some  matter,  lay  under  the 
other  part  of  the  same  bone.  I made  two 
perforations  with  the  trephine,  close  to  the 
fracture,  that  I might  raise  it  up  steadily 
through  both,  and  have  more  room  for  the 
extravasated  blood  to  discharge  from  under 
the  scull,  which  had  discharged  before  in 
) great  quantity  through  the  fracture.  But 


) 


TABLES. 


nevertheless,  ten  days  after  the  former  opera- 
tion, I was  obliged  to  make  .another  perfora- 
tion to  discharge  the  matter  more  freely  j for, 
during  a month,  the  matter  ran  through  all 
her  dressings  down  her  face  twice  every  day, 
and  was  exceedingly  fetid,  and  for  the  space 
of  three  months  the  matter  decreased  very 
little  in  quantity,  but  grew  less  and  less  of- 
fensive. September  tire  thirteenth,  the  least 
of  the  bones  was  taken  out  ; and  on  Sep- 
tember the  twenty  ninth,  the  large  one ; 
after  which  time  the  matter  was  good,  and 
not  too  much  in  quantity.  Each  of  these 
bones  is  through  both  tables,  for  the  motion 
in  the  brain  was  seen,  only  some  little  parts 
of  the  lesser  bone  remaining,  a callus  was 
formed  from  them  ; but  where  the  great  one 
came  away  there  was  no  callus,  only  a com- 
mon cicatrix  ; and  besides  these,  many  little 
bits  of  bone  came  away  in  the  dressings : she 
was  soon  after  cured,  and  has  remained  well 
many  years. 


TAB.  xxx  vm 


TABLES. 


321 


TABLE  XXXVIII. 

The  figure  of  Samuel  Wood,  a miller,  whose 
arm  with  the  scapula  was  torn  off  from  his 
body,  by  a rope  winding  round  it,  the  other 
end  being  fastened  to  the  coggs  of  a mill. 
This  happened  in  the  year  1737.  The  vessels 
being  thus  stretched  bled  very  little,  the  arte- 
ries and  nerves  were  drawn  out  of  the  arm  ; 
the  surgeon  who  was  first  called  placed  them 
within  the  wound,  and  dressed  it  superficially. 
The  next  day  he  was  put  under  Mr.  Ferne’s 
care,  at  St.  Thomas’s  hospital,  but  he  did  not 
remove  the  dressings  for  some  days.  The  pa- 
tient had  no  severe  symptoms,  and  the  wound 
was  cured  by  superficial  dressings  only,  the  nat- 
ural skin  being  left  almost  sufficient  to  cover 
it ; which  should  in  all  cases  be  done  as  much  as 
may  be.  About  twenty  years  since  I introduced 
the  method  of  amputating,  by  first  dividing  the 
skin  and  membrana  adiposa,  lower  than  the  place 
where  the  operation  was  to  be  finished,  the  ad- 
vantages of  which  are  now  sufficiently  known. 

1 The  end  of  the  clavicle. 

2 The  cicatrix. 

3 The  subscapularis  muscle. 

4 The  cubit  broke  in  two  places. 


322 


TABLES. 


TABLE  XXXIX 


Represents  the  case  of  John  Heysham,  whoy 
the  Friday  before  Easter,  in  the  year  1721,  by 
overstraining  himself  at  work,  had  a rupture 
of  the  intestines  into  the  scrotum,  which  could 
by  no  means  be  reduced.  He  Was  brought 
into  St.  Thomas’s  hospital  the  Monday  follow- 
ing, and  I would  have  performed  the  operation 
immediately,  but  he  refusing  to  submit,  it  was 
deferred  till  Tuesday  morning,  when,  he  be- 
ing willing,  I performed  the  operation,  and 
making  a large  wound  in  the  bottom  of  the 
abdomen,  the  intestines  were  easily  reduced, 
and  near  a quart  of  water  wa:  discharged  out 
of  the  scrotum  at  the  same  _ me.  There  had 
been  a rupture  of  the  omentum  before,  which 
being  united  to  the  scrotum  and  spermatic  ves- 
sels, I passed  a needle  with  a double  ligature 
(as  is  expressed  in  the  plate)  under  that  part 
of  the  omentum  that  adhered,  so  as  not  to 
hurt  the  spermatic  vessels  ; then  cutting  out 
the  needle,  I tied  one  of  the  strings  over  the 
upper  part  of  the  omentum,  and  the  other 
over  the  lower,  and  then  cut  off  as  much  of 
it  as  was  in  the  way.  My  reason  for  tying  in 
this  manner  was  to  secure  the  blood  vessels, 
which,  I think,  could  not  be  done  so  well 
with  one  ligature,  because  of  the  largeness  of 


TABLES, 


S2S 

the  adhesion  and  the  texture  of  the  omentum., 
which  renders  it  too  liable  to  be  torn  by  such 
a bandage.  Three  days  after  the  operation  an 
erysipelas  began  in  his  legs,  and  spread  all  over 
his  body,  the  cuticle  every  where  peeling  off  j 
yet  he  recovered,  and  continues  in  a good  state 
of  health.  After  he  was  cured,  at  first  he  wore 
a small  truss,  but  left  it  off  in  a short  time, 
and  now  feels  no  inconvenience  from  it,  though 
he  lives  by  hard  labour. 


324 


TABLES. 


TABLE  XL. 

The  case  of  Margaret  White,  the  wife  of 
John  White,  a pensioner  in  the  Fishmongers 
alms-houses  at  Newington  in  Surry.  In  the 
fiftieth  year  of  her  age,  she  had  a rupture  at 
her  navel,  which  continued  till  her  seventy- 
third  year,  when,  after  a fit  of  the  colic,  it 
mortified,  and  she  being  presently  after  taken 
with  a vomiting,  it  burst.  I went  to  her,  and 
found  her  in  this  condition,  with  about  six  and 
twenty  inches  and  a half  of  the  gut  hanging 
out,  mortified.  1 took  away  what  was  morti- 
fied, and  left  the  end  of  the  sound  gut  hanging 
out  at  the  navel,  to  which  it  afterwards  ad- 
hered ; she  recovered  and  lived  many  years 
after,  voiding  the  excrements  through  the  in- 
testine at  the  navel  j and  though  the  ulcer  was 
so  large,  after  the  mortification  separated,  that 
the  breadth  of  two  guts  was  seen  ; yet  they 
never  at  any  time  protruded  out  at  the  wound, 
though  she  was  taken  out  of  her  bed,  and  sat  up 
every  day. 

1 The  gut. 

2 The  cicatrix  of  the  wound. 


TAB. XT, 


F.  3% 


CUTTING  FOR  THE  STONE, 


325 


CHAPTER  VII. 

A SHORT  HISTORICAL  ACCOUNT  OF  CUTTING  FOR 
THE  STONE. 

The  most  ancient  way  of  cutting  for  the 
stone  is  that  described  by  Celsus,  which  was 
indeed  cutting  upon  the  gripe,  but  in  a very  dif- 
ferent manner  from  that  operation  in  later  ages, 
for  he  directs  a lunated  incision  with  the  horns 
towards  the  coccyges,  which  was  plainly  that  the 
gut  might  be  pressed  downwards  to  avoid  wound- 
ing it,  and  then  a transverse  incision  upon  the 
stone  might  be  made  safely,  but  not  in  very  young 
children,  for  want  of  room,  nor  after  puberty, 
for  then  the  prostatse  are  too  large  to  allow  of 
this  operation  ; therefore  they  did  not  usually  cut 
any  younger  than  nine  years,  nor  older  than  four- 
teen. Afterwards,  but  when  we  know  not,  this 
operation  was  improved  by  cutting  lower,  and  on 
one  side,  which  is  the  operation  now  called  cutting 
on  the  gripe,  or  with  the  lesser  apparatus. 

In  the  year  1524,  Marianus  published  the 
method  of  cutting  by  the  greater  apparatus,  now 
commonly  called  the  old  way,  but  he  owns  it  was 
invented  by  his  master  Johannes  de  Romanis. 

In  the  year  1697,  Frere  Jacques  came  to 
Paris,  full  of  reputation  for  the  success  of  his  new 
operation  for  the  stone  ; he  soon  obtained  leave  to 
cut  in  the  hospitals,  where  great  numbers  of  his 


326 


CUTTING  FOR  THE  STONE. 


patients  dying,  and  being  dissected,  they  were 
found  with  their  bladders  cut  through,  guts 
wounded,  &c.  which  brought  the  operation  into 
disgrace,  as  Mery  and  Dionis  have  related,  who 
saw  these  things.  They  say  he  performed  the  ope- 
ration without  any  direction,  and  without  any 
knowledge  of  the  parts  he  was  to  cut ; a thing  not 
to  be  mentioned  without  horror ! But  of  late  his 
character  has  been  set  in  a very  different  light  j 
and  though  it  is  more  than  probable  he  himself 
knew  not  what  he  did,  yet  there  are  now,  who  pre- 
tend to  tell  us  exactly  ; though  if  their  testimonies 
are  to  be  regarded,  who  saw  him  operate,  there  is 
no  place  that  he  did  not  cut  one  time  or  other,  and 
therefore  he  may  have  a sort  of  right  to  be  called 
the  inventor  of  any  operation  for  the  stone  that  can 
ever  be  performed  in  these  parts.  It  is  also  owned 
that  he  sometimes  had  great  success,  which  was 
enough  to  put  others  of  that  nation  upon  trying  of 
it  in  a more  judicious  manner  ; but  if  there  were 
such,  failing  of  success,  they  have  concealed  their 
experiments. 

Mr.  Rau  of  Amsterdam,  who  saw  F.  Jacques 
operate,  professed  to  do  his  operation  with  the 
necessary  improvement  of  a grooved  staff,  which  if 
Jacques  ever  used,  he  surely  learned  that  of 
Rau.  He  succeeded  wonderfully ; and  if  he,  who 
was  an  excellent  anatomist,  may  be  allowed  to 
understand  his  own  operation,  it  was  directly  into 
the  bladder,  without  wounding  either  the  urethra 


CUTTING  FOR  THE  STONE.  327 

4r  the  prostrates  : besides  this,  other  competent 
judges,  who  were  witnesses  to  his  operations,  have 
bore  the  same  testimony. 

In  the  year  1717-18,  Doctor  James  Doug- 
lass, in  a paper  presented  to  the  Royal  Society, 
demonstrated  from  the  anatomy  of  the  parts,  that 
the  high  operation  for  the  stone  might  be  prac- 
tised; which  had  been  once  performed  by  Franco 
injudiciously,  and  by  him  disrecommended,  though 
his  patient  recovered ; and  afterwards  strongly 
recommended,  but  not  practised  by  Rosset.  Yet 
no  one  undertook  it,  till  his  brother,  Mr.  John 
Douglass,  about  three  years  after,  performed  it, 
and  with  great  applause,  his  two  first  patients  re- 
covering. Soon  after,  a surgeon  of  St.  Thomas’s 
hospital  cut  two,  who  both  recovered  ; but  the 
same  gentleman  afterwards  cutting  two,  who  mis- 
carried by  the  cutting  or  bursting  of  the  peritonae- 
um, so  that  the  guts  appeared,  this  way  imme- 
diately became  as  much  decried  as  it  was  before 
commended  ; upon  which  the  surgeons  of  St.  Bar- 
tholomew’s hospital,  who  had  prepared  to  perform 
this  operation,  altered  their  resolution,  and  went 
on  in  the  old  way.  The  next  season,  it  being  my 
turn  in  St.  Thomas’s,  I resumed  the  high  way, 
and  cutting  nine  with  success,  it  came  again  in 
vogue ; after  that  every  lithotomist  of  both  hos- 
pitals practised  it  ; but  the  peritonaeum  being 
often  cut  or  burst  twice  in  my  practice,  though 
some  of  these  recovered,  and  sometimes  the 


32&  CUTTING  FOR  THE  STONE. 

bladder  itself  was  burst,  from  injecting  too  muck 
water,  which  generally  proved  fatal  in  a day  or 
two.  Another  inconvenience  attended  every  ope- 
ration of  this  kind,  which  was,  that  the  urine’s 
lying  continually  in  the  wound  retarded  the  cure, 
but  then  it  was  never  followed  with  an  inconti- 
nence of  urine.  What  the  success  of  the  several 
operators  was,  I will  not  take  the  liberty  to  pub- 
lish ; but  for  my  own,  exclusive  of  the  two  before 
mentioned,  I lost  no  more  than  one  in  seven, 
which  is  more  than  any  one  else  that  I know  of 
could  say  ; whereas  in  the  old  way,  even  at  Paris, 
from  a fair  calculation  of  above  800  patients,  it 
appears  that  near  two  in  five  died.  And  though 
this  operation  came  into  universal  discredit,  I must 
declare  it  my  opinion,  that  it  is  much  better  than 
the  old  way,  to  which  they  all  returned,  except 
myself,  who  would  not  have  left  the  high  way 
but  for  the  hopes  I had  of  a better  ; being  well 
assured,  that  it  might  hereafter  be  practised  with 
greater  success  ; these  fatal  accidents  having  pret- 
ty well  shewn  how  much  water  might  be  inject- 
ed, and  how  large  the  wound  might  safely  be 
made.  But  hearing  of  the  great  success  of  Mr. 
Rau,  professor  of  anatomy  at  Leyden,  I deter- 
mined to  try,  though  not  in  his  manner,  to  cut 
directly  into  the  bladder ; and  as  his  operation  was 
an  improvement  of  Friar  Jacques,  I endeavoured 
to  improve  upon  him,  by  filling  the  bladder,  as 
Douglass  had  done  in  the  high  way,  with  water. 


cutting  £or  The  ston£.  329 

leaving  the  catheter  in,  and  then  cutting  on  the 
outside  of  the  catheter  into  the  bladder,  in  the 
same  place  as  upon  the  gripe,  which  I could  do 
very  readily,  and  take  out  a stone  of  any  size  with 
more  ease  than  in  any  other  way.  My  patients, 
for  some  days  after  the  operation,  seemed  out  of 
danger  ; but  the  urine  which  came  out  of  the 
bladder  continually  lodging  upon  the  Cellular 
membrane  on  the  outside  of  the  rectum,  made 
foetid  ulcers,  attended  with  a vast  discharge  of 
stinking  matter  : and  from  this  cause  I lost  four 
patients  out  of  ten.  The  case  of  one  which  escaped 
was  very  remarkable  ; a few  days  after  he  was 
cut,  he  was  seized  with  a great  pain  in  his  back 
and  legs,  with  very  little  power  to  move  them  ; 
upon  which  he  turned  upon  his  face,  and  rested 
almost  constantly  upon  his  knees  and  elbow's  above 
a fortnight  together,  having  no  ease  in  any  other 
posture  all  that  while  ; at  length  his  urine  coming 
all  the  right  way,  his  wound  soon  healed,  and  he 
recovered  the  use  of  his  back  and  limbs.  I think 
all  these  severe  symptoms  could  proceed  from  no 
other  cause  than  the  urine  and  matter  somehow 
offending  the  great  nerves  ; which  come  out  of 
the  os  sacrum  to  2:0  to  the  lower  limbs.  I then 

o 

tried  to  cut  into  the  bladder,  in  the  same  manner 
that  Mr.  Rau  was  commonly  reported  to  do,  but 
there  had  the  same  inconvenience  from  the  urine’s 
lodging  upon  the  cellular  membrane  on  the  out« 
side  of  the  intestinum  rectum.  Upon  these  dis» 
t t 


330  CUTTING  TOR  THE  STOnU. 

appointments,  I contrived  the  manner  of  cutting^ 
which  is  now  called  the  lateral  way.  This  ope- 
ration I do  in  the  following  manner  : I tie  the 
patient  as  for  the  greater  apparatus,  but  lay  him 
upon  a blanket  several  doubles  upon  an  horizontal 
table  three  feet  high,  with  his  head  only  raised. 
I first  make  as  long  an  incision  as  I can,  beginning 
near  the  place  where  the  old  operation  ends,  and 
cutting  down  between  the  musculus  accelerator 
urinae,  and  erector  penis,  and  by  the  side  of  the' 
intestinum  rectum  : I then  feel  for  the  staff, 
holding  down  the  gut  all  the  while  with  one  or 
two  fingers  of  my  left  hand,  and  cut  upon  it  ill 
that  part  of  the  urethra  which  lies  beyond  the 
corpora  cavernosa  urethrae,  and  in  the  prostate 
gland,  cutting  from  below  upwards,  to  avoid 
wounding  the  gut  ; and  then  passing  the  gorget 
very  carefully  in  the  groove  of  the  staff  into  the 
bladder,  bear  the  point  of  the  gorget  hard  against 
the  staff,  observing  all  the  while  that  they  do 
not  separate,  and  let  the  gorget  slip  to  the  out- 
side of  the  bladder  ; then  I pass  the  forceps  into 
the  right  side  of  the  bladder,  the  wound  being 
on  the  left  side  of  the  perinaeum  ; and  as  they 
pass,  carefully  attend-  to  their  entering  the  blad- 
der, which  is  known  by  their  overcoming  a strait- 
ness  which  there  will  be  in  the  place  of  the  wound  j, 
then  taking  care  to  push  them  no  farther,  that 
the  bladder  may  not  be  hurt,  I first  feel  for  the 
stone  with  the  end  of  them,  which  having;  felt. 


CUTTING  FOR  THE  STONE. 


331 


I open  the  forceps  and  slide  one  blade  underneath 
it,  and  the  other  at  top  ; and  if  I apprehend  the 
stone  is  not  in  the  right  place  of  the  forceps,  I 
shift  it  before  I offer  to  extract,  and  then  extract 
it  very  deliberately,  that  it  may  not  slip  suddenly 
out  of  the  forceps,  and  that  the  parts  of  the 
wound  may  have  time  to  stretch,  taking  great  care 
not  to  gripe  it  so  hard  as  to  break  it,  and  if  I find 
the  stone  very  large,  I again  cut  upon  it  as  it  is 
held  in  the  forceps.  Here  I must  take  notice,  it  is 
very  convenient  to  have  the  bladder  empty  of  urine 
before  the  operation,  for,  if  there  is  any  quantity 
to  flow  out  of  the  bladder  at  the  passing  in  of  the 
gorget,  the  bladder  does  not  contract  but  collapse 
into  folds,  which  makes  it  difficult  to  lay  hold 
<of  the  stone  without  hurting  the  bladder  ; but 
if  the  bladder  is  contracted,  it  is  so  easy  to  lay 
hold  of  it,  that  I have  never  been  delayed  one 
moment,  unless  the  stone  was  very  small.  Last- 
ly, I tie  the  blood  vessels  by  the  help  of  a crook- 
ed needle,  and  use  no  other  dressing  than  a lit- 
tle bit  of  lint  besmeared  with  blood,  that  it  may 
not  stick  too  long  in  the  wound,  and  all  the  dress- 
ings during  the  cure  are  very  slight,  almost  super- 
ficial, and  without  any  bandage  to  retain  them  r, 
because  that  will  be  wetted  with  urine,  and  gall 
the  skin.  At  first  I keep  the  patient  very  cool  to 
prevent  bleeding,  and  sometimes  apply  a rag  dipt 
in  cold  water,  to  the  wound,  and  to  the  genital 
parts,  which  I have  found  very  useful  in  hot 


332  CUTTING  FOR  THE  STONE. 

weather  particularly.  In  children  it  is  often  alone 
sufficient  to  stop  the  bleeding,  and  always  helpful 
in  men.  The  day  before  the  operation,  I give  a 
purge  to  empty  the  guts,  and  never  neglect  to 
give  some  laxative  medicine  or  clyster  a few  days 
after,  if  the  belly  is  at  all  tense,  or  if  they  have  not 
a natural  stool.  What  moved  me  to  try  this  way, 
if  I may  be  allowed  to  know  my  own  thoughts, 
was  the  consideration  of  women  scarce  ever  dying 
of  this  operation  ; from  which  I concluded,  that  if 
I could  cut  into  the  urethra,  beyond  the  corpora  ca- 
vernosa urethrae,  the  operation  would  be  nearly  as 
safe  in  men  as  women. 

What  success  I have  had  in  my  private  practice 
I have  kept  no  account  of,  because  I had  no  inten- 
tion to  publish  it,  that  not  being  sufficiently  wit- 
nessed. Publicly  in  St.  Thomas’s  hospital  I have 
cut  two  hundred  and  thirteen  ; of  the  first  fifty, 
only  three  died  ; of  the  second  fifty,  three  ; of  the 
third  fifty,  eight ; and  of  the  last  sixty  three,  six. 
Several  of  these  patients  had  the  smallpox  during 
their  cure,  some  of  whom  died,  but  I think  not 
more  in  proportion  than  what  usually  die  of  that 
distemper  ; these  are  not  reckoned  among  those 
who  died  of  the  operation.  The  reason  why  so 
few  died  in  the  two  first  fifties  was,  at  that  time 
few  very  bad  cases  offered  ; in  the  third,  the  ope- 
ration being  in  high  request,  even  the  most  aged 
and  most  miserable  cases  expected  to  be  saved  by 
it  3 besides,  at  that  time,  I made  the  operation 


CUTTING  TOR  THE  STONE. 


333 


lower,  in  hopes  of  improving  it,  but  found  I 
was  mistaken.  But  what  is  of  most  conse* 
quence  to  be  known  is  the  ages  of  those  who  re* 
covered,  and  those  who  died.  Of  these,  under 
ten  years  of  age  one  hundred  and  five  were  cut, 
three  died  ; between  ten  and  twenty,  sixty  two 
cut,  four  died  ; twenty  and  thirty,  twelve  cut, 
three  died  ; thirty  and  forty,  ten  cut,  two  died ; 
forty  and  fifty,  ten  cut,  two  died  ; fifty  and 
sixty,  seven  cut,  four  died ; sixty  and  seventy, 
five  cut,  one  died ; between  seventy  and  eighty, 
two  cut,  one  died.  Of  those  who  recovered  the 
three  biggest  stones  were  ^ xii,  x|,  and  viii,  and 
the  greatest  number  of  stones  in  any  one  person 
was  thirty  three.  One  of  the  three  that  died  out 
of  the  hundred  and  five,  was  very  ill  with  a 
whooping  cough  ; another  bled  to  death  by  an 
artery  into  the  bladder,  it  being  very  hot  weather 
at  that  time  : but  this  accident  taught  me  after* 
wards,  whenever  a vessel  bled  that  I could  not 
find,  to  dilate  the  wound  with  a knife,  till  I 
could  see  it.  Now  if  Jacques  or  others,  who 
of  late  have  been  said  to  have  performed  this 
operation,  whether  by  design  or  chance,  did  not 
take  care  to  secure  the  blood  vessels,  which  as 
yet  has  not  been  supposed,  whatever  their  dexter- 
ity in  operating  might  be,  their  suceess  at  least 
can  be  no  secret,  for  many  of  their  children  and 
jnost  of  their  men  patients  must  have  bled  to 
plealh.  If  I have  any  reputation  in  this  way? 


334 


CUTTING  TOR  THE  STONE. 


I have  earned  it  dearly,  for  no  one  ever  endured 
more  anxiety  and  sickness  before  an  operation,  yet 
from  the  time  I began  to  operate,  all  uneasiness  ceas- 
ed ; and  if  I have  had  better  success  than  some  oth- 
ers, I do  not  impute  it  to  more  knowledge,  but  to 
the  happiness  of  a mind  that  was  never  ruffled  or 
disconcerted,  and  a hand  that  never  trembled  during 
any  operation. 


INDEX 


A 


DIPOSE  membrane 


its  diseases 


Alantois 

Amnion 


137 

138 
280 
278 


does  its  liquor  serve  as  nourishment  ? 


Amputation,  how  is  the  circulation  kept  up  after  it  ? 203 

- — occasioned,  and  proving  fatal  from  the  cramp  207 

«— — in  mortifications  ought  to  succeed  the  sepa- 
ration ......  208 

Anasarca  = - - - - 130 

Anchylosis , how  formed  ...  8 

Aneurism  - - - - - 187 

Animal  body,  what  1 

— — ■ — — its  constituent  parts  ...  2 

Animal,  why  larger  have  slower  pulses,  and  less  vig- 
our in  motion  ...  200 

— — — why  inactive  ones  require  less  food,  and  are 

not  so  suddenly  destroyed  by  wounds  - 207 

Antra.  Vide  Sinus  maxillce  sup. 

Aorta , frequently  ossified  near  the  heart  - - 182 

— - — • its  valves  covered  with  chalk  - - 182 

■ preternaturally  distended  - - - 182 

— — - traced  - - . - - 183 

Aqueous  humour  of  the  eye  ....  296 

Arm,  right,  why  more  used  than  the  left  - 24 

Artery,  coronary  - - - =184 

*— carotids,  why  rising  differently  - - 184 


336 


INDEX. 


Arteiy,  cervical  - 

subclavian,  axillary,  Etc.-  * t 

■ intercostal,  See.  - 

phrenic,  &c.  - 

iliac  - 

~ inguinal,  &c,  - 

pulmonary  . «■ 

Arteries,  what  J'  - * 

• become  bony 

coats  - - 

the  angles  and  laws  of  ramification 

the  force  of  their  contractions 


186 

- 186 

188 
188 
- 189 

190 
183 

- 2 
5 

194,  200 

195 

196 


motion  of  the  blood  in  them  and  in  the  veins  199,  &c. 

Arachnoides  of  the  brain  - - - - - 221 

Atlas , or  first  ’vertebra  22 

Barrenness  of  women  - 276 

Bile,  in  what  quantity  - « . 164 

concreting,  forms  stones  - - - 166 

Biliary  ducts  - - - - 163 

obstructed  - - ~ ~ - 166 

Bladder  of  urine  ^ 260 

seldom  ulcerated  - 261 

Blood,  quantity,  celerity  of  its  motion,  &c.  - 206 

- — — extravasated,  requires  first  purging,  and  then 

warm  attenuant  - 208 

Blood  letting  - - - 89 

what  artery  in  danger  - - - 187 

Bones,  what  - . 3 

- — — use  - 4 

fibres  - - - - 4,  9 

— — — how  ossify  and  grow  » 4 

■ — - sometimes  decrease  or  waste  - 5 

• — — why  hollow  & 


337 

Page 

7 

7 

9 

9 


INDEX. 

Bones,  their  place  supplied  by  shells  in  small  animals 

broken,  how  united  by  the  callus 

■- — — have  not  visible  lamella  ... 

• their  compact  and  spongy  substance 

distorted  or  fractured,  cured  by  an  indurating 

paste  ...  -37 

■  their  diseases,  particulai'ly  caries  - S3 

■  of  the  cranium  - - - - 11 

—  trunk  - - - - 21 

—  upper  limb  - - - 29 

- — ■ — lower  limb  ...  34 

— — internal  ear  ...  3 07 

Bony  excrescences  ....  5 

Brain  .....  222 

• — — full  of  water  in  a lethargy  - . 224 

— — its  state  in  an  apoplexy  ...  224 

- — scirrhous  humours  in  the  cerebrum  - 225 

imposthumations  of  the  cerebrum  - 225 

Breast  and  its  cancer  ...  . 140 

Cacum , or  appendix  vermiformis  - • 156 

Callus , unites  fractured  bones  - - 7 

Canalis  arteriosus  ....  284- 

Cancer  - 140 

Caries  of  bones  - - - . 39 

Carpus , bones  of  32 

Cartilages,  what  - - - . 3 

— — ■ subject  to  ossification 
- — — swelled  in  rickets  - 

— — prevent  contiguous  moveable  bones  from  uniting 

—  eroded,  occasion  anchylosis 


where  placed  and  use 
moveable  in  the  joint  of  the  jaw 


5 
5 
8 
8 

41,  &c. 
41 


U U 


SB'S  tND"ETC. 

Fa igji: 

Cartilages,  semilunur  in  the  knee  - Z 42 

Cartilago  ensiformis  - - - - 28 

Caruncula  lachrymalis  » 291 

Carunculce  myrtiformes  ...  273 

urethrae  - 268 

Castration,  how  to  secure  the  vessels  - - 265 

Catamenia  - - - - -2  75 


Cataract,  why  the  patient  does  not  discern  objects, 


though  sensible  of  light  and  colours  - 300 

Cerebellum  .....  223 

its  wounds  cause  sudden  death  - - 224 

Cerebrum  .....  222 

■  its  wounds  n9t  mortal  ...  224 

Chorion  - - 278 

Choroides  oeuli  - - 293 

Circulation,  the  complete  revolution  - - 217 

■ - in  small  vessels,  and  in  living  animals  - 204 

Clavicida  .....  29 

Clitoris  .....  272 

Colon  - - - - - -156 


Conception  ....  269,  276 

Conjunctiva  oculi  •>  291 

Cornea  oculi  .....  291 

» — a great  refractor  of  light  - - 298 

Couching,  not  so  much  refraction  in  the  eye  after  the 

operation  ....  298 

history  of  a young  gentleman  - - 300 

Cowper , Mr.  his  operation  on  the  antrum  - 19 

Cramp,  occasioning  first  amputation,  and  then  death  207 
Cranium , why  composed  of  several  bones  - 12 

Crystalline  humour  ....  297 

■ a lens  for  refraction  297,  298,  299 

134 


Guticula 


INDEX* 


Cuticula , its  diseases 
Cutis 


— — - small  painful  tumours  under  it 
Chylification  - 

Deafness  caused  by  redundant  cerumen 
— — - in  some  cases,  perhaps,  might  he  cured  by  per- 
forating the  membrana  tympani 
— = — in  three  cases,  probably,  prevented  by  blistering 
immediately  after  birth 

■— — • caused  by  the  polypus  of  the  nose  compressing 
the  Eustachian  tube 
Dentes.  Vide  Teeth. 

Digestion  of  the  aliment  ...  152, 

Dislocation  of  the  thigh 

— — — — — ■ knee  ... 

Dropsy  and  tapping  .... 

— = — ■ of  the  liver 

— — true  ascites  never  cured  ... 

— — in  the  duplicature  of  the  peritonaeum  148, 

Ductus  arteriosus  .... 


— — — how  closed  ... 

■ — thoracicus  .... 

— venosus  .... 

Duodenum  ..... 

Dura  mater  ..... 

—  — its  sinuses  . 

—  ossified  ....  221, 

Ear,  external  .... 

imposthumes  of 

membrana  tympani  ... 


naturally  perforated 
broke  in  a dog,  without  caus- 
ing deafness 


335 

Page 

134 

135 

136 
216 

305 

306 
306 
308 

, 216 

44 

45 
211 
212 
215 
149 
284 
28/ 
169 
283 
155 
218 
219 
319 

304 

305 
305 
305 

305 


340 


INDEX. 


Page 

Ear,  membrana  tympani  destroyed  by  ulcer,  and  the 

small  bones  thrown  out,  without  deafness  305 

306 
30  7 

308 

309 
309 
138 
265 

8 

234 
269 
3 

39,  40 


— — - ■ ■ ■ ■ its  perforation  proposed 

— small  bones,  with  muscles  of  the  malleus 

Eustachian  tube  - 

■ stapes  with  its  muscle 

labyrinth  - 

Emphysema  - 

Epididymis  - 

Epyphysis  of  bones  . 

Epigastrium  - - 

Erection  of  the  penis  - - 

Excretory  vessel  - 

Exfoliation  of  bones  - - 

Extravasation.  Vide  Blood. 

Eye  - - - - - 

• — tunica  conjunctiva  - 

— sclerotis  et  cornea  ... 

— iris  processus  ciliares  - 

■ — tunica  choroides  - 

• — retina  - 

— humours  of  ------ 

— inflammations  of,  require  immediate  assistance 

— membrana  nictitans , in  amphibious  animals,  not  for 

refraction  - 

Feeling,  the  sense  of 
Females,  why  fewer  born  than  males 
Fibres,  what  ----- 

Fibula  ------ 

Figures  of  the  bones. 


290 

291 
291 
291 
293 
293 

296 
299 

297 
311 
275 

2 

36 


1.  The  skeleton  of  a child  twenty  months  old^J 

I 

The  thigh  bone  of  a man  sawed  through  }>  50 

■ 

The  os  bregmatis  of  a foetus  of  six  months  J 


INDEX. 


} 


341 

Page 

■2.  The  head  with  the  lower  jaw  - - - 51 

3.  A section  of  the  scull  and  upper  jaw 

The  os  sphenoides  - - 

The  inside  of  the  base  of  the  scull 

4.  The  trunk  .... 

5.  The  vertebra  - 

6.  Bones  of  the  arm,  fore-arm,  and  carpus 

7.  The  hand  - 

8.  The  thigh  and  leg  of  the  skeleton 

9.  The  foot  of  the  skeleton 

10.  The  adult  skeleton  - 

Figures  of  the  muscles. 

11.  A muscular  busto  - 

12.  The  fore  view  of  a muscular  trunk 

13.  The  back  view  of  the  same 

14.  Two  muscular  arms  - 

15.  A muscular  arm  and  leg- 

16.  Two  muscular  legs  - 

17.  A muscular  hand  - 

Figures  of  the  muscles. 

1 8.  A.  muscular  foot  - 

19.  A complete  muscular  figure 

20.  The  muscular  figures  of  Hercules  and  Antaeus  1 31 
Figures  of  the  viscera. 

21.  Viscera  of  the  abdomen  and  thorax  in  situ  249 

22.  The  liver,  pancreas , spleen,  and  kidneys, 

with  the  large  vessels  of  the  abdomen , and 
contents  of  th e pelvis  - 250 

23.  The  lacteals  of  the  jejunum 


52 

53 

54 

55 

56 

57 

58 

59 

122 

123 

124 

125 

126 

127 

128 

129 

130 


The  origin  and  distribution  of  the  supe- 
rior mesenteric  artery 

24.  A full  view  of  the  vena  portarum 

25.  The  vena  hepaticce 

The  biliary  and  pancreatic  ducts 


| 251 


} 


252 


542 


INDEX, 


26.  Receptaculum  chyli  et  ductus  thoracicus 

27.  The  superior  and  inferior  cubital  nerves 
Course  and  distribution  of  humeral  artery 

2,8.  The  parts  concerned  in  V.  S.  brachii 

A tumor  extirpated  from  the  cubital  nerve 
29.  The  medulla  spinalis 
The  intercostal  nerve 
SO.  The  animalcules  in  semhie 

The  circulation  in  a fish’s  tail 
A small  artery  and  a vein  spread  On  a 
membrane 

Figures  of  the  organs  of  generation. 

31.  The  bladder,  with  the  prostate  gland, 

vesiculce  seminales , See. 

A transverse  section  of  the  penis 
A longitudinal  section  of  the  penis 

32.  The  female  organs  of  generation 

33.  The  parts  of  two  different  hermaphrodites 
Figures  of  the  foetus. 

34.  The  heart,  with  its  large  vessels 
'The  heart,  with  th t foramen  ovale 
The  venal  system  of  the  liver 

Figures  of  the  Eye,  and  Cases  of  Surgery. 

35.  A diagram  to  illustrate  vision,  and  the  dark 

or  insensible  point  of  the  eye 

36.  The  operation  of  imperforated  iris 
The  operation  for  proptosis  cornea; 

A diagram,  whence  dimness  of  sight  from 
an  opacity  of  the  cornea 
A diagram,  whence  the  sense  of  light  in 
a cataractous  eye  - 

37.  An  ossification  in  the  dura  mater 

in  the  heart 

Two  exfoliations  of  both  tables  of  the  scull- 


Pag® 

254 


} 

} 

} 


255 

256 

257 


r 


258 


J>  312 

« 

■ 

I 

J 

313 

314 

j-  315 
j-  316 

» 317 
}318 


INDEX. 


38.  Wood,  the  miller 

39.  The  Bubonocele  performed  on  Hey  sham 

40.  White’s  exomphalos 
Fingers,  bones  of 

Fistula  in  ano 
perincEO 

Flea,  why  numerous  joints  in  its  legs 
Fluids,  their  proportion  to  the  solids 
Fcetus , it  is  nourished  by  the  mouth 
— — receives  red  blood  from  the  mother 
circulation  of  its  blood 


Foramen  ovale 

. how  closed 

- not  open  in  water  animals 

Fra  cture,  how  united  by  callus 
how  bound  up  with  a paste 


__ — — — of  the  scull 
Funis  umbilicalis 
Gall-bladder 
Ganglion  of  nerves 
Gland,  what 
=—  structure 
— — lacrymal 
lymphatic 
— — . miliary 

mucilaginous,  of  joints 

- — - pineal 

— pituitary 

— — salivary 
________ — economy 

thymus 

— — thyroide 
Glandules  renales 


543 

Pag® 

321 

322 

- 324 

33 

72, 1 57 
26  7 

7 

- 206 
278 
182 

- 284 

284 
28  7 
288 
7 

- 3 7 
319 
283 
163 
227 

3 

146 
290 
212 
. 136 

47 

213,  223 
213,  222 

- 142 

- 145 

- 213 

. 213 

263 


344 


Index. 


Gonorrhcca  « - - - » 

Gutta  serena  state  of  the  brain  and  optic  nerves 
Haemorrhage,  why  commonly  on  surfaces 
Haemorrhoides,how  extirpated 
Hanging  kills  by  interrupting  respiration 
Heart  - 


Page’ 

268 

22  S 
202 
158 

m 

177 


ossification  of  its  muscular  fibres  5,  182,  31$ 

— its  basis  ulcerated,  with  pus  in  the  pericardium  181 

— large,  lax,  and  filled  with  polypi  in  fatal  dropsies  181 

its  force  - - - - 196 

■  systole  and  diastole,  why  reciprocal  . 197 

■  throws  the  blood  along  the  whole  arterial  system  200 

Hernia . Vide  Rupture. 

aquosa  - 264 

Hydrocele  - - - - 263 

Hymen  - 273 

■  imperforated  ....  273 

Hypochondrium  - - - - 134 

Hypogastrium  - - - - 134 

Jaundice  - - - - - 166 

Jaw,  lower,  not  ossified  - - - 5 

Jejunum  - - - - - 156 

Ileum  intestinum  - - - - 156 

Iliac  passion  - - - - 160 

Imposthumations,  their  seat  - - 139 

Injection  through  the  arteries  into  the  veins  - 203 

Intestines  - 155,- — 158 

why  such  a length  of  - - 156 

joint  of  the  thigh  imposthumated  - - 29 

diseases  of  ....  48 

Iris  ------  291 

— — acts  as  a sphincter  muscle  - - 292 

Kidneys  - - 295 


INDEX. 


Kidneys  tubuli , papilla,  glands,  and  pelvis 

one  frequently  almost  consumed 

* — sometimes  but  one  ... 

Labia  pudendi  - 

Labour,  child  bearing,  why  at  the  usual  time 
Lacteals  - - - 

Ligament,  what  .... 

where  placed,  and  uses 

Ligamenium  uteri  rotundum  - 
latum  - - - 


Lithotomy,  an  account  of 

Liver  ....  .... 

— — - diseased  ...... 

Lobster,  its  shells  and  joints  .... 
Lungs  ..4..... 
Luxations  of  the  spine  most  commonly  at  the  lower 
dorsal  vertebras  - 

Lymphseducts  ...  ... 

Males,  why  more  born  than  females 
Mammae  ....... 

— — — ■ cancerous  ...... 

Marrow,  oily  ....... 

•  bloody  ....... 

cells,  vesicles,  &c.  .... 

Maxillary  gland  ....  - 

•  scirrhous  proving  fatal  in  nine  weeks 

Mediastinum  ...... 

Medulla  oblongata  ...... 

— — — — wounded,  causes  sudden  death 


345 

Paa:e 

260 


272 

272 

289 

168 

3 

43,  &c. 
274 
274 
325 
161 
165 
212 
7 

172 


■ — spinalis  - 

Membrana  oblongata , its  wounds 
Membrana  adiposa 


26 

2,  206 
275 

139 

140 
5 

5 

6 
143 
143 
172 
224 
224 
224 
224 
137 


W W 


346 


INDEX. 


Pagf? 

133 


s 


Membrana  adiposa , its  diseases 

— tympani.  Vide  Ear. 

nictitans.  Vide  Eye. 

Membrane,  what  - - - 2,  61 

containing,  investing,  &c.  - - 141 

Mesentery  - - - - - 160 

Metacarpus  - - - - 33 

Metatarsus , bones  of  - - - - 37 

Miller,  history  of  the  loss  of  his  arm  - 321 

lions  Veneris  - - - - 272 

Mortification,  should  separate,  before  we  amputate  208 
Muscles,  what  -----  3 

their  fibres  supposed  vesicular  - - 62 

rectilineal,  penniform,  use  - - 62,  &c. 

of  the  abdomen  - - 67 

- — of  the  genitals  and  anus  69 

of  the  scalp,  ear,  eye,  lips,  and  nose  - 72 

of  the  os  hyoides,  tongue,  larynx , pharynx , 

and  uvula  - - - 78 

of  the  lower  jaw  * - - 82 

-* of  the  clavicula  and  scapida  - 83 

• — of  the  os  humeri  - 85 

of  the  fore  arm  and  hand  - - 88 

of  the  head  and  neck  - - - 97 

of  respiration,  spine,  and  pelvis  - 102 

— of  the  thigh  and  leg  - -*•  - 108 

— of  the  foot  and  toes  - - - 115 

— of  the  ossicida  auditus  - - 307,  309 

Nephrotomy,  what  passes  for  that  operation  - 260 

Nerves,  what  - - - 2,  225,  246 

ganglions  ...  227,  247 

instruments  of  sensation  and  of  motion  247 

* — whether  vibrating  cords  or  traductory  tubes  228,  247 


XXDEX. 


Nerves,  seem  to  decussate  - 

the  order  of  dissecting  them  - 

of  encephalon  and  medulla  spinalis 

—  first  pair  - - 

second  pair  ------ 

— - — - probably  decussate 

=_ — third  pair  - 

fourth  ------- 

fifth 

seventh  - 

— — ninth 

tenth  ----- 

— — of  the  medidla  spinalis  - 
first  cervical  - 

second  ------ 

third  - 

fourth,  fifth,  sixth,  and  seventh  cervical,  with 

the  first  dorsal  - 

the  twelve  dorsal  - - - 

— — - the  five  lumbar  - 

the  sacral  - - - - - 

Nicholls , Dr.  his  opinion  of  the  sphenoidal  sinuses 
Nymphce  ------- 

Oesophagus  - 

Omentum  - - 

Os  tincce  - - - 

— cethmoides  ------- 

— coccygis  - - 

— femoris  - - - - - 

* — front  is  - - - - - 

«*—  humeri 


347 

Page 

294 

240 

229 

230 

231 
294 

231 

232 
232 

235 

236 
236 
238 
238 
240 

240 

241 

241 

242 
244 

244 

245 
14 

272 

150 

149 

274 

13 

22,  25 
3 

12 

31 


348 


Index. 


Os  innominatum  - 

— maxilla:  inferioris  .... 

superioris  ... 

• — nasi  - 

— occipitis  .... 

— paldti  ..... 

— pari  et  ale  .... 

— petrosum  - - 

— planum  - .... 

— sacrum  ....... 

— sphenoides  ...... 

■ — spongiosum  ..... 

■ — temp  or  is  ...  - 

• — vomer  - 

Ossa  etiquetra  .... 

Ossicula  auditus  ..... 
Ossification  in  the  o'ara  mater 

— heart  ... 

Ossifying  matter,  deficient  in  a lower  jaw,  and  in 
the  rickets  - - 


Ovaria 
Pancreas 
Paracentesis 
Parotis , gland 


Patella 


its  duct  wounded 
ulcerated 


— how  united  when  broken 

Penis  - - - 

Pericardium  ... 

containing  pus 

adhering  to  the  heart 


Pagce 

28 

17 
20 

18 

17 

16 

19 
12 
15 

18 

22,  25 
13 

20 
15 
20 

8,  11 

307 

319 

319 

5 

274 

165 

111 

142 

143 
143 

35 

35 

267 

1177 

181 

181 

10 


Pericranium 


INDEX. 


349 

Page 

Periosteum  - - - - 10 

thickened  in  rickets  5 

Peritonaeum  - - - - 148 

Pi  a mater  - - - - - 221 

— ossified  - 221 

Placenta  - - - - 2 81 


its  vessels  anastomose  with  those  of  the  uterus  282 


Pleura  - - - - - 172 

Pleuritic  pains,  why  more  commonly  in  the  left  side  178 
Polypus  of  blood  . 210 

Pope’s  eye  in  brutes  ....  214 

Processus  ciliares  - 292 

Procidentia  ani  - - - - 157 

Prostatas  - 266 

diseased  - 266 

Papilla  - - - - - 291 

— — how  contracted  and  opened  - 292 

— why  round  and  oval  in  different  animals  292 


Radius  - 32 

Receptaculum  chyli  - - - - 168 

Rectum  intestinum  - - - - 157 

Regio  umbilicahs  - - - - 133 

Respiration,  motions,  - 104,  &c. 

use  - - - - 173 

Reticulum  mucosum  - - - - 135 

Retina  ......  293 

Ribs,  fractured  or  distorted  by  careless  nurses  - 27 

Rupture  of  matter,  and  probably  of  the  gut,  under 

Fallopius' s ligament  - - 47 

of  matter,  and  of  blood  and  matter  into  the 

fore  part  of  the  thigh  - - 190 

* — of  water  - 264 


case  of  Heysham 


350 


INDEX. 


Page 

Kupture,  case  of  White  - 324 

Sanguification  - - . «■  217 

Scl'erotis  tunica  oculi  ....  291 

Scapula  - - - . . 2 7 

Scarifications,  when  hurtful  - 208 

Scrobicidis  cordis  - - - . 133 

Scurvy,  how  affects  the  cuticula  - - 134 

Scull.  Vide  Cranium. 

fractured  - - - * 319 

Secretion,  how  performed  - - . 147 

Seed,  the  nature  of  its  animalcules  - - 269 

Sella  turcica  - - - * - 1 3 

Sinus , frontal  - - - - - 13 

of  the  os  sphenoides  - - - 14 

■ of  the  maxillary  bone  - - - 1 9 

■ — — sometimes  imposthumatecl  19 

Slcin  - - - - - *135 

Smelling,  the  sense  of  - - * 310 

Solids,  their  proportion  to  fluids  - - 206 

Spine,  bones  of  - - - - 21 

■ — — why  composed  of  so  many  bones  * 22 

• final  causes  of  its  different  curvatures  - 23 

Spleen  - - - - - 167 

Sternum  - - - - - 27 

Stomach  - - - - - 151 

Stones,  extracted  from  the  loins  - - 260 

Stone,  symptoms  of,  equivocal  - •>  261 

— account  of  the  operation  - - 325 

Sublingual  gland  - 143 

Suppression  of  urine,  in  the  kidneys  and  in  the  blad- 
der, different  - * - 262 

— how  to  be  treated  - 262 

Sutures,  how  formed  * - - - « 


Index* 


Sutures,  what  .... 

*  particular  ones  ... 

Tapping  for  the  dropsy 

Tarsus , bones  of  - - 

Tasting,  the  sense  of 

Teeth  1 

shed  - - - - 

Tendons,  what  - 

pricked  in  bleeding  - 

Testes  ...... 

Thymus , gland  .... 

Tonsilla  glandules  .... 

* how  extirpated  ... 

Tooth-ache,  its  seat  ...  - 

'Trepan,  not  applic-^le  at  the  frontal  sinus 
Tuba  Fallopiana  .... 

Tumours,  small  ones  under  the  skin  giving  exquisite 
pain  ..... 

Vagina  ..... 

Vasa  deferentia  .... 

Vein,  what  ..... 

■ coats  ....  194, 

■  why  curved  in  its  course 

■  why  cutaneous  on  the  arm 

cava,  with  its  branches 

cephalic,  how  avoided  in  cutting  issues 

portarum  - .... 

•  in  the  feetus  ... 

pulmonary  ... 


Vena  lactea 
Vertebra 

their  classes 


bodies,  processes 


551 

Page 

311 

311 

211 

36 

311 

20 

21 

3 

89 

263 

213 

144 

144 

21 

13 

275 

136 

273 

266 

2 

205 

194 

192 

191 

192 

193 
283 
183 
168 

21 

22 

2^ 


352 


index. 


Vertebra ?,  supernumerary  - 

Vesiculce  seminales  - 

Vision,  the  retina , the  organ  of 

caused  by  an  impulse  on  the  retina 

how  carried  on  after  couching 

— why  do  objects  appear  single 

why  do  not  objects  appear  inverted 

observations  from  a young  gentleman,  who 

never  saw  till  couched 
Vitreous  humour  - 

Ulna  ...... 

Ureters  - 

■  distended  in  calculous  patients 

Urethra  . ...  . 

— — its  glands  - 

■  strictures  - 

in  women  - 

Urine  passes  only  by  the  ureters 
Uterus  - 

White  swelling 


FINIS. 


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— 

DUKE  UNIVERSITY 
MEDICAL  CENTER  LIBRARY 
HISTORY  OF  MEDICINE  COLLECTIONS 

Gift  of  the  Estate  of 
GST  Cavanagh 

* r 

rn 

